17 terms

Evolution of MI

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How long before ischemia is irreversible?
45 min
0-4 hr Risk
Arrhythmia
CHF exacerbation
Cardiogenic shock
4-12 hr Gross
Dark mottling, pale with tetrazolium stain
4-12 hr LM
Early coagulative necrosis, edema, hemorrhage, wavy fibers
4-12 hr Risk
Arrhythmia
12-24 hr gross
Dark mottling, pale with tetrazolium stain
12-24 hr LM
Contraction bands (reperfusion injury)
Release of necrotic cell content -> blood
Begin neutrophil migration
12-24 hr Risk
Arrhythmia
1-3 d Gross
Hyperemia
1-3 d LM
Extensive coagulative necrosis
Tissue surrounding infarct shows acute inflammation
Neutrophil migration
1-3 d Risk
Fibrinous pericarditis overlying necrotic myocardium (disappears w/ 1-3 d aspirin)
3-14 d Gross
Hyperemic border, central yellow-brown softening - max yellow and soft by 10 d
3-14 d LM
Macrophage infiltration followed by granulation tissue at margins
3-14 d Risk
Free wall rupture -> tamponade, papillary muscle rupture, ventricular aneurysm, interventricular septal rupture due to macrophages that have degraded impt structural components
2 wks - several mos Gross
Recanalized artery, Gray-white
2 wks - several mos LM
Contracted scar complete
2 wks - several mos Risk
Dressler's syndrome