Ruptured intercalated discs: Difference between revisions

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[[File:Histopathology of ruptured intercalated discs.jpg|thumb|Ruptured intercalated discs, in this case regarded as a visual artifact, and was not reported.]]
[[File:Histopathology of ruptured intercalated discs.jpg|thumb|Ruptured intercalated discs, in this case regarded as a visual artifact, and was not reported.]]
Ruptured intercalated discs of myocytes of the '''[[heart]]''' have two main causes:
Ruptured intercalated discs of myocytes of the '''[[heart]]''' have two main causes:
*'''Microtome processing''', thereby being a visual artifact,<ref>[https://books.google.se/books?id=7SxiDwAAQBAJ&pg=PA38 Page 38] in: {{cite book|title=The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition|author=Giorgio Baroldi|publisher=CRC Press|year=2004|isbn=9781498712811}}</ref> not needing reporting.
*'''Microtome processing''', thereby being a visual artifact,<ref>[https://books.google.se/books?id=7SxiDwAAQBAJ&pg=PA38 Page 38] in: {{cite book|title=The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition|author=Giorgio Baroldi|publisher=CRC Press|year=2004|isbn=9781498712811}}</ref> not needing reporting.
*'''Forceful myocardial contraction''', at least in case of [[heart autopsy]]. This is mainly caused by ventricular fibrillation<ref name=Fineschi2016>[https://books.google.se/books?id=PcsqBgAAQBAJ&pg=PA55 Page 55] in: {{cite book|title=Pathology of the Heart and Sudden Death in Forensic Medicine|author=Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver|publisher=CRC Press|year=2016|isbn=9781420006438}}</ref> or electric shock,<ref name="FineschiKarch2005">{{cite journal|last1=Fineschi|first1=Vittorio|last2=Karch|first2=Steven B.|last3=D'Errico|first3=Stefano|last4=Pomara|first4=Cristoforo|last5=Riezzo|first5=Irene|last6=Turillazzi|first6=Emanuela|title=Cardiac pathology in death from electrocution|journal=International Journal of Legal Medicine|volume=120|issue=2|year=2005|pages=79–82|issn=0937-9827|doi=10.1007/s00414-005-0011-8}}</ref>
*'''Forceful myocardial contraction''', at least in case of [[heart autopsy]]. This is mainly caused by ventricular fibrillation<ref name=Fineschi2016>[https://books.google.se/books?id=PcsqBgAAQBAJ&pg=PA55 Page 55] in: {{cite book|title=Pathology of the Heart and Sudden Death in Forensic Medicine|author=Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver|publisher=CRC Press|year=2016|isbn=9781420006438}}</ref> or electric shock,<ref name="FineschiKarch2005">{{cite journal|last1=Fineschi|first1=Vittorio|last2=Karch|first2=Steven B.|last3=D'Errico|first3=Stefano|last4=Pomara|first4=Cristoforo|last5=Riezzo|first5=Irene|last6=Turillazzi|first6=Emanuela|title=Cardiac pathology in death from electrocution|journal=International Journal of Legal Medicine|volume=120|issue=2|year=2005|pages=79–82|issn=0937-9827|doi=10.1007/s00414-005-0011-8}}</ref>
Additional signs indicating forceful myocardial contraction, and thereby the mentioning of the findings in the report, are:<ref name=Fineschi2016/><ref name="FineschiKarch2005"/>
If a lab often cause it as a visual artifact, it may be ignored in the report.<ref group="notes">Repeated artifacts from a lab motivates measures to improve techniques.</ref> If not, look for signs indicating forceful myocardial contraction, and thereby the mentioning of the findings in the report. Such signs are:<ref name=Fineschi2016/><ref name="FineschiKarch2005"/>
*Alternating bundles of hypercontracted myocytes with hyperdistended ones.
*Alternating bundles of hypercontracted myocytes with hyperdistended ones.
*Square-shaped myocardiocyte nuclei.
*Square-shaped myocardiocyte nuclei.
*Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes.
*Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes.
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<gallery mode=packed heights=200>
File:Free nuclei from myocardiocytes.jpg|Cases with ruptured intercalated discs often also display free myocardial nuclei or nuclear fragments, which should not be confused with a lymphocytic infiltrate.
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Latest revision as of 10:54, 4 December 2022

Author: Mikael Häggström [note 1]

Ruptured intercalated discs, in this case regarded as a visual artifact, and was not reported.

Ruptured intercalated discs of myocytes of the heart have two main causes:

  • Microtome processing, thereby being a visual artifact,[1] not needing reporting.
  • Forceful myocardial contraction, at least in case of heart autopsy. This is mainly caused by ventricular fibrillation[2] or electric shock,[3]

If a lab often cause it as a visual artifact, it may be ignored in the report.[notes 1] If not, look for signs indicating forceful myocardial contraction, and thereby the mentioning of the findings in the report. Such signs are:[2][3]

  • Alternating bundles of hypercontracted myocytes with hyperdistended ones.
  • Square-shaped myocardiocyte nuclei.
  • Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes.

Notes

  1. Repeated artifacts from a lab motivates measures to improve techniques.
  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. Page 38 in: Giorgio Baroldi (2004). The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition . CRC Press. ISBN 9781498712811. 
  2. 2.0 2.1 Page 55 in: Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver (2016). Pathology of the Heart and Sudden Death in Forensic Medicine . CRC Press. ISBN 9781420006438. 
  3. 3.0 3.1 Fineschi, Vittorio; Karch, Steven B.; D'Errico, Stefano; Pomara, Cristoforo; Riezzo, Irene; Turillazzi, Emanuela (2005). "Cardiac pathology in death from electrocution ". International Journal of Legal Medicine 120 (2): 79–82. doi:10.1007/s00414-005-0011-8. ISSN 0937-9827. 

Image sources