fresh myocardial infarction ICD-10: I21
weitere Informationen auf HiPaKu (akut, transmural)
Mann, 66 J., Angina pectoris, jetzt Thoraxschmerz, ausstrahlend in den linken Arm,
kardiogener Schock. Autopsiepräparat
- Im Myokard schachbrettartige, zackig begrenzte Zonen mit Koagulationsnekrose
der Myokardfasern
- Fehlende Kerne, Sarkoplasma eosinophil, homogen oder schollig
- Am Rande der Nekrosezonen massive Infiltration von neutrophilen Granulozyten
- Im epikardialen Fettgewebe Infiltrate von Granulozyten
- Auf dem Epikard zottige Fibrindecke (z.T. abgerissen)
- Subendokardiale Myokardiozyten erhalten
Makroskopie:
Koronarthrombose bei Koronarsklerose
Vergleich: Präparate A III 14, A
IV 11
Male, 66 y., had a history of angina pectoris. He experienced prolonged chest pain radiating down the arm,
cardiogenic shock ensued (specimen from autopsy).
- A transmural section of the left ventricle is shown.
- A vast, irregular area is observed with extensive coagulative necrosis (Koagulationsnekrose)
of cardiomyocytes. The latter exhibit a homogenous hypereosinophilic
cytoplasm and loss of nuclei. The necrosis is partly demarcated by an infiltrate of neutrophils.
- The visceral pericardium is infiltrated by inflammatory cells and covered by a layer of fibrin.
- A small subendocardial layer of viable cardiomyocytes is preserved, some displaying vacuolar degeneration.
Macroscopy:
arteriosclerotic coronary artery obstruction with formation of an occlusive thrombus
Compare: slides A III 14, A
IV 11