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Pathology Education Instructional Resource β

IPLab:Lab 3:Acute Myocardial Infarction

Contents

Clinical SummaryEdit

This 78-year-old male experienced a posterior myocardial infarction six years prior to this admission. Recently, he had begun to experience occasional angina. Four days prior to death, he experienced anterior chest pain and discomfort which he regarded as not too distressing. However, EKGs showed a classic acute anterior myocardial infarction in addition to the healed posterior infarct. His bloodwork also showed an elevated troponin. The patient progressively deteriorated with signs of left ventricular failure and died with arrhythmias and pulmonary edema.

At autopsy his heart showed a healed posterior infarct. The right coronary artery was completely occluded but partially recanalized. The left main coronary artery had severe atherosclerotic stenosis and a thrombus filling the lumen. The entire anterolateral aspect of the left ventricle was soft with variegated areas appearing hyperemic or pale. There was extensive mural thrombosis and reactive pericarditis.

ImagesEdit

Virtual MicroscopyEdit

Heart: Acute Myocardial InfarctionEdit

Normal HeartEdit

Study QuestionsEdit


Additional ResourcesEdit

Related IPLab CasesEdit

Myocardial infarction is necrosis of myocardial tissue which occurs as a result of a deprivation of blood supply, and thus oxygen, to the heart tissue. Blockage of blood supply to the myocardium is caused by occlusion of a coronary artery.

Angina pectoris is chest pain produced by myocardial ischemia, it worsens upon exertion.

Arrhythmias are abnormal heart rhythms.

Pulmonary edema refers to the accumulation of fluid in the pulmonary alveolar and tissue spaces as a result of changes in capillary permeability and/or increases in capillary hydrostatic pressure.

Recanalization is the process of the forming of channels through an organized thrombus so that blood flow is restored.

A thrombus is a solid mass resulting from the aggregation of blood constituents within the vascular system.

Mural thrombosis is the formation of multiple thrombi along an injured endocardial wall.

Pericarditis is inflammation of the pericardium - often with deposition of fibrin.

Mural thrombosis is the formation of multiple thrombi along an injured endocardial wall.

An occlusion is a blockage.