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Difference between revisions of "Myocardial infarction"
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Myocardial infarction (view source)
Revision as of 20:32, 15 November 2015
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| Caption = Contraction band necrosis - a finding of MI. [[H&E stain]]. | | Caption = Contraction band necrosis - a finding of MI. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = wavy fibers, myocyte [[necrosis]] with loss of cross striations, [[contraction band necrosis|contraction bands]], edema, hemorrhage, neutrophilic infiltrate, pyknosis of nuclei, loss of nuclei (karyolysis) | | Micro = early to late: wavy fibers, myocyte [[necrosis]] with loss of cross striations, [[contraction band necrosis|contraction bands]], edema, hemorrhage, neutrophilic infiltrate, pyknosis of nuclei, loss of nuclei (karyolysis), macrophage and mononuclear infiltration, fibrovascular response, [[granulation tissue]], myocardial fibrosis | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[cardiac amyloidosis]] for old infarct, [[myocarditis]] | | LMDDx = [[cardiac amyloidosis]] for old infarct, [[myocarditis]] | ||
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| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = myocardial pallor, hyperemia (redness), yellow lesion with hyperemic border, white (fibrosis) | | Gross = early to late: myocardial pallor, hyperemia (redness), yellow lesion with hyperemic border, white (fibrosis) | ||
| Grossing = | | Grossing = | ||
| Site = [[heart]] | | Site = [[heart]] | ||
| Assdx = [[coronary artery atherosclerosis]]+/-plaque rupture, +/-thrombosis, cocaine use | | Assdx = [[coronary artery atherosclerosis]]+/-plaque rupture, +/-thrombosis, [[cocaine]] use | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = +/-tachycardia, +/-diaphoresis (sweating), +/-hypotension | ||
| Symptoms = classic findings: retrosternal chest pain +/- with radiation down the arms, nausea | | Symptoms = classic findings: retrosternal chest pain +/- with radiation down the arms, nausea +/- vomiting, +/-[[shortness of breath]] | ||
| Prevalence = | | Prevalence = | ||
| Bloodwork = elevated troponin, CK-MB | | Bloodwork = elevated troponin, CK-MB | ||
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| Endoscopy = | | Endoscopy = | ||
| Prognosis = dependent on extent | | Prognosis = dependent on extent | ||
| Other = | | Other = abnormal EKG - especially ST elevation | ||
| ClinDDx = varies by presentation - usu. [[aortic dissection]], [[acute pneumonia]], [[pulmonary embolism]], GI | | ClinDDx = varies by presentation - usu. [[aortic dissection]], angina, [[acute infectious pneumonia]], [[pulmonary embolism]], pericarditis, chest wall pain, anxiety, GI disease, others | ||
| Tx = | | Tx = | ||
}} | }} | ||
'''Myocardial infarction''', abbreviated '''MI''', is death of cardiac muscle due to a compromised blood supply. In the context of pathology, they are occasionally seen at [[autopsy]]. | '''Myocardial infarction''', abbreviated '''MI''', is death of cardiac muscle due to a compromised blood supply. In the context of pathology, they are occasionally seen at [[autopsy]]. | ||
The lay term for MI is '''heart attack'''. | |||
==General== | ==General== | ||
===Clinical=== | ===Clinical=== | ||
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===Image=== | ===Image=== | ||
<gallery> | <gallery> | ||
Image | Image: Heart ant wall infarction.jpg | MI - gross. (WC) | ||
Image: Heart_ant_wall_scar_sa.jpg | Myocardial scar - gross. (WC) | |||
</gallery> | </gallery> | ||
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*6 weeks - Fibrosis. | *6 weeks - Fibrosis. | ||
Images: | ===Images=== | ||
www: | |||
*[http://path.upmc.edu/cases/case158/micro.html MI (upmc.edu)]. | *[http://path.upmc.edu/cases/case158/micro.html MI (upmc.edu)]. | ||
<gallery> | |||
Image: Myocardial infarct emmolition phase histopathology.jpg | MI - inflammation. (WC) | |||
</gallery> | |||
===Contraction band necrosis=== | ===Contraction band necrosis=== | ||
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==See also== | ==See also== | ||
*[[Heart]]. | *[[Heart]]. | ||
*[[Cardiovascular pathology]]. | |||
*[[Infarct]]. | |||
*[[Necrosis]]. | |||
*[[Congestive heart failure]]. | |||
==References== | ==References== | ||
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[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category: | [[Category:Cardiovascular pathology]] | ||