IPLab:Lab 1:Myocardial Infarction: Difference between revisions

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== Study Questions ==
== Study Questions ==
* What type of necrosis is present in this myocardial tissue?
* <spoiler text="What type of necrosis is present in this myocardial tissue?">Coagulative necrosis.</spoiler>
<spoiler>Coagulative necrosis.</spoiler>
* <spoiler text="What are the morphologic characteristics of coagulative necrosis?">Hypereosinophilia, coagulation of cellular proteins, and loss of nuclei (pyknosis, karyolysis, and karyorrhexis).</spoiler>
* What are the morphologic characteristics of coagulative necrosis?
* <spoiler text="What causes the vacuolar change seen in the tissue adjacent to this infarct and is this change reversible or irreversible injury?">The vacuolar change (hydropic change) seen in myocytes at the edge of an infarct is a REVERSIBLE CHANGE caused by CELLULAR EDEMA.


* What causes the vacuolar change seen in the tissue adjacent to this infarct and is this change reversible or irreversible injury?
At the edge of an infarct the oxygen tension is low (hypoxia) so there is a decrease in oxidative metabolism and an increase in anaerobic glycolysis. Since anaerobic glycolysis is less efficient than aerobic metabolism there are lower ATP levels which result in impaired osmotic regulation. In addition, metabolic metabolites accumulate which further increases the intracellular osmotic load and leads to cellular edema.</spoiler>
 
== Additional Resources ==
 
=== Reference ===
* [http://emedicine.medscape.com/article/155919-overview eMedicine Medical Library: Myocardial Infarction]
* [http://www.merckmanuals.com/professional/cardiovascular_disorders/coronary_artery_disease/acute_coronary_syndromes_acs.html Merck Manual: Acute Coronary Syndromes]
 
== Journal Articles ==
* Agnew NM, Pennefather SH, Russell GN.  [http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2044.2002.02469.x/full Isofluorane and coronary heart disease].  ''Anaesthesia'' 2002; 57(4): 338-347


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