Autopsy of myocardial infarction - Revision history

Mikael Häggström: 220

2022-06-23T21:40:14Z

220

← Older revision		Revision as of 17:40, 23 June 2022
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	===Topography===		===Topography===
	Classify the topographic distribution of any myocardial infarction, if possible:		Classify the topographic distribution of any myocardial infarction, if possible:
	<gallery mode=packed heights=~~190~~>		<gallery mode=packed heights=220>
	File:Patterns of topographic distribution of myocardial infarction.jpg		File:Patterns of topographic distribution of myocardial infarction.jpg
	</gallery>		</gallery>

Mikael Häggström: Note

2022-06-19T20:46:13Z

Note

← Older revision		Revision as of 16:46, 19 June 2022
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	! Time !! Gross examination !! Histopathology <br> (light microscopy)		! Time !! Gross examination !! Histopathology <br> (light microscopy)
	\|-		\|-
	\| 0 - 0.5 hours \|\| None<ref group=~~notes~~ name=elec>		\| 0 - 0.5 hours \|\| None<ref group=note name=elec>
	For the first ~30 minutes no change at all can be seen by [[gross examination]] or by light microscopy in histopathology. However, in electron microscopy relaxed myofibrils, as well as glycogen loss and mitochondrial swelling can be observered.</ref> \|\| None<ref group=~~notes~~ name=elec></ref>		For the first ~30 minutes no change at all can be seen by [[gross examination]] or by light microscopy in histopathology. However, in electron microscopy relaxed myofibrils, as well as glycogen loss and mitochondrial swelling can be observered.</ref> \|\| None<ref group=note name=elec></ref>
	\|-		\|-
	\| 0.5 – 4 hours \|\| None<ref group=~~notes~~>It is often possible, however, to highlight the area of necrosis that first becomes apparent after 2 to 3 hours by immersion of tissue slices in a solution of triphenyltetrazolium chloride. This dye imparts a brick-red color to intact, noninfarcted myocardium where the dehydrogenase activity is preserved. Because dehydrogenases are depleted in the area of ischemic necrosis (i.e., they leak out through the damaged cell membranes), an infarcted area is revealed as an unstained pale zone. Instead of a triphenyltetrazolium chloride dye, a LDH (lactate dehydrogenase) dye can also be used to visualize an area of necrosis.</ref> \|\|		\| 0.5 – 4 hours \|\| None<ref group=note>It is often possible, however, to highlight the area of necrosis that first becomes apparent after 2 to 3 hours by immersion of tissue slices in a solution of triphenyltetrazolium chloride. This dye imparts a brick-red color to intact, noninfarcted myocardium where the dehydrogenase activity is preserved. Because dehydrogenases are depleted in the area of ischemic necrosis (i.e., they leak out through the damaged cell membranes), an infarcted area is revealed as an unstained pale zone. Instead of a triphenyltetrazolium chloride dye, a LDH (lactate dehydrogenase) dye can also be used to visualize an area of necrosis.</ref> \|\|
	*Glycogen Depletion, as seen with a PAS Stain		*Glycogen Depletion, as seen with a PAS Stain
	*Possibly waviness of fibers at border		*Possibly waviness of fibers at border
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	\|-		\|-
	\| More than 2 months		\| More than 2 months
	\| Completed scarring<ref group=~~notes~~ name=ageinfarct></ref>		\| Completed scarring<ref group=note name=ageinfarct></ref>
	\| Dense collagenous scar formed<ref group=~~notes~~ name=ageinfarct>		\| Dense collagenous scar formed<ref group=note name=ageinfarct>
	Once scarring is completed, there is yet no common method of discerning the actual age of the infarct, since e.g. a scar that is four months old looks identical to a scar that is ten years old.</ref>		Once scarring is completed, there is yet no common method of discerning the actual age of the infarct, since e.g. a scar that is four months old looks identical to a scar that is ten years old.</ref>
	\|-		\|-

Mikael Häggström:

2022-06-19T04:06:46Z

</noinclude>

← Older revision		Revision as of 00:06, 19 June 2022
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	{{Top		<noinclude>{{Top
	\|author1=[[User:Mikael Häggström\|Mikael Häggström]]		\|author1=[[User:Mikael Häggström\|Mikael Häggström]]
	\|author2=		\|author2=
	}}		}}
	'''[[Heart autopsy]]''' in possible myocardial infarction:		'''[[Heart autopsy]]''' in possible myocardial infarction:
	{{Autopsy - comprehensiveness\|otherlegend=yes}}		{{Autopsy - comprehensiveness\|otherlegend=yes}}</noinclude>
	{{Heart - standard autopsy cutting\|coronary note= ''More details in section below.''\|header=		{{Heart - standard autopsy cutting\|coronary note= ''More details in section below.''\|header=
	==Autopsy cutting checklist==		==Autopsy cutting checklist==

Mikael Häggström: heights

2021-12-10T22:06:39Z

heights

← Older revision		Revision as of 18:06, 10 December 2021
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	==Autopsy cutting checklist==		==Autopsy cutting checklist==
	}}		}}
	<gallery mode=packed heights=~~220~~>		<gallery mode=packed heights=210>
	File:Gross pathology of a one week old myocardial infarction with focal rupture.jpg\|A one week old myocardial infarction of the posterior left ventricle, with focal rupture, in fresh state (left) and after formalin fixation (right). The infarcted area is pale whereas the rupture is hemorrhagic (dark red).		File:Gross pathology of a one week old myocardial infarction with focal rupture.jpg\|A one week old myocardial infarction of the posterior left ventricle, with focal rupture, in fresh state (left) and after formalin fixation (right). The infarcted area is pale whereas the rupture is hemorrhagic (dark red).
	File:Gross pathology of old myocardial infarction.jpg\|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).		File:Gross pathology of old myocardial infarction.jpg\|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).

Mikael Häggström: Expanded

2021-12-10T22:05:11Z

Expanded

← Older revision		Revision as of 18:05, 10 December 2021
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	==Autopsy cutting checklist==		==Autopsy cutting checklist==
	}}		}}
	[[File:Gross pathology of old myocardial infarction.jpg\|~~thumb\|230px~~\|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).]]		<gallery mode=packed heights=220>
			File:Gross pathology of a one week old myocardial infarction with focal rupture.jpg\|A one week old myocardial infarction of the posterior left ventricle, with focal rupture, in fresh state (left) and after formalin fixation (right). The infarcted area is pale whereas the rupture is hemorrhagic (dark red).
			File:Gross pathology of old myocardial infarction.jpg\|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).
			</gallery>
	Look for areas of fibrosis ({{further\|Myocardial fibrosis\|linebreak=no}}) or hemorrhage. Sample tissue from suspected areas, at least in cases where a diagnosis cannot be made from gross examination alone.		Look for areas of fibrosis ({{further\|Myocardial fibrosis\|linebreak=no}}) or hemorrhage. Sample tissue from suspected areas, at least in cases where a diagnosis cannot be made from gross examination alone.

Mikael Häggström: /* Microscopy of the myocardium */ img

2021-09-10T12:09:51Z

Microscopy of the myocardium: img

← Older revision		Revision as of 08:09, 10 September 2021
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	\| Interstitial edema \|\| 4–12 h \|\| \|\| \|\| [[File:Histopathology of interstitial edema in myocardial infarction.jpg\|190px]]		\| Interstitial edema \|\| 4–12 h \|\| \|\| \|\| [[File:Histopathology of interstitial edema in myocardial infarction.jpg\|190px]]
	\|-		\|-
	\| Coagulative necrosis: ‘nuclear changes’ \|\| 12–24 (pyknosis, karyorrhexis) \|\| 1–3 days (loss of nuclei) \|\| Depends on size of infarction \|\|		\| Coagulative necrosis: ‘nuclear changes’ \|\| 12–24 (pyknosis, karyorrhexis) \|\| 1–3 days (loss of nuclei) \|\| Depends on size of infarction \|\| [[File:Histopathology of myocardial infarction with loss of nuclei.jpg\|190px]]
	\|-		\|-
	\| Neutrophil infiltration \|\| 12–24 h \|\| 1–3 days \|\| 5–7 days \|\| [[File:Histopathology of neutrophil infiltration in myocardial infarction.jpg\|190px]]		\| Neutrophil infiltration \|\| 12–24 h \|\| 1–3 days \|\| 5–7 days \|\| [[File:Histopathology of neutrophil infiltration in myocardial infarction.jpg\|190px]]

Mikael Häggström: Higher resolution

2021-09-09T11:59:23Z

Higher resolution

← Older revision		Revision as of 07:59, 9 September 2021
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	\| Neutrophil infiltration \|\| 12–24 h \|\| 1–3 days \|\| 5–7 days \|\| [[File:Histopathology of neutrophil infiltration in myocardial infarction.jpg\|190px]]		\| Neutrophil infiltration \|\| 12–24 h \|\| 1–3 days \|\| 5–7 days \|\| [[File:Histopathology of neutrophil infiltration in myocardial infarction.jpg\|190px]]
	\|-		\|-
	\| Neutrophil karyorrhexis \|\| 1.5–2 days \|\| 3–5 days \|\| \|\| [[File:Histopathology of ~~heavy granulocyte infiltration~~ with karyorrhexis ~~in myocardial infarction~~.jpg\|190px]]		\| Neutrophil karyorrhexis \|\| 1.5–2 days \|\| 3–5 days \|\| \|\| [[File:Histopathology of myocardial infarction with karyorrhexis and few lymphocytes.jpg\|190px]]
	\|-		\|-
	\| Macrophages and lymphocytes \|\| 3–5 days \|\| 5–10 days (including ‘siderophages’) \|\| 10 days to 2 months \|\| [[File:Histopathology of macrophages and lymphocyte infiltration with early removal of necrotic debris in myocardial infarction.jpg\|190px]]		\| Macrophages and lymphocytes \|\| 3–5 days \|\| 5–10 days (including ‘siderophages’) \|\| 10 days to 2 months \|\| [[File:Histopathology of macrophages and lymphocyte infiltration with early removal of necrotic debris in myocardial infarction.jpg\|190px]]

Mikael Häggström: +Image

2021-08-18T21:08:32Z

+Image

← Older revision		Revision as of 17:08, 18 August 2021
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	==Autopsy cutting checklist==		==Autopsy cutting checklist==
	}}		}}
			[[File:Gross pathology of old myocardial infarction.jpg\|thumb\|230px\|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).]]
	Look for areas of fibrosis ({{further\|Myocardial fibrosis\|linebreak=no}}) or hemorrhage. Sample tissue from suspected areas, at least in cases where a diagnosis cannot be made from gross examination alone.		Look for areas of fibrosis ({{further\|Myocardial fibrosis\|linebreak=no}}) or hemorrhage. Sample tissue from suspected areas, at least in cases where a diagnosis cannot be made from gross examination alone.

Mikael Häggström: /* Gross processing of coronary arteries */ Linked

2020-12-28T14:06:12Z

Gross processing of coronary arteries: Linked

← Older revision		Revision as of 10:06, 28 December 2020
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	*{{Finding-begin}}Any vessel grafts to the heart{{Finding-end}}		*{{Finding-begin}}Any vessel grafts to the heart{{Finding-end}}

	Estimate the percentage of any significant stenosis or occlusion.		Estimate the percentage of any significant stenosis or occlusion. {{Further\|Arteries\|linebreak=no}}
	<gallery mode=packed>		<gallery mode=packed>
	File:Plaque at different degrees of atherosclerotic stenosis.jpg\|Plaque at different percentages of atherosclerotic stenosis.<ref name="MichaudBasso2019"/>		File:Plaque at different degrees of atherosclerotic stenosis.jpg\|Plaque at different percentages of atherosclerotic stenosis.<ref name="MichaudBasso2019"/>

Mikael Häggström: /* Topography */ height

2020-12-10T15:30:08Z

Topography: height

← Older revision		Revision as of 11:30, 10 December 2020
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	===Topography===		===Topography===
	Classify the topographic distribution of any myocardial infarction, if possible:		Classify the topographic distribution of any myocardial infarction, if possible:
	<gallery mode=packed>		<gallery mode=packed heights=190>
	File:Patterns of topographic distribution of myocardial infarction.jpg		File:Patterns of topographic distribution of myocardial infarction.jpg
	</gallery>		</gallery>