

Pathology Essay

2534 words - 11 pages

Pathology: Myocardial Infarction

1. Discuss myocardial infarction and its pathogenesis.
2. Describe the sequence of changes involved in myocardial infarction.
3. List the major physiologic and morphologic complications of myocardial infarction.
4. Describe management of myocardial infarction.
5. Discuss patient teaching of myocardial infarction.
Myocardial infarction (MI), commonly known as a heart attack, is an irreversible necrosis of the heart muscle secondary to prolonged ischemia. This usually results from an imbalance in oxygen supply and demand, which is most often caused by plaque rupture with thrombus formation in a ...view middle of the document...

The damage in the myocardium is essentially the result of a tissue response that includes apoptosis (cell death) and inflammatory changes. Therefore, the heart of patients who suddenly die from an acute coronary event may show little or no evidence of damage response to the myocardium at autopsy. The typical MI initially manifests as coagulation necrosis that is ultimately followed by myocardial fibrosis. Contraction-band necrosis is also seen in many patients with ischemia. This is followed by reperfusion, or it is accompanied by massive adrenergic stimulation, often with concomitant myocytolysis. The left coronary artery system covers more territory than does the right coronary artery system; therefore, a MI in this system is most likely to produce extensive injury, with impairment of function, pulmonary congestion, and low cardiac output. Thus, the pathogenesis can include:
• Occlusive intracoronary thrombus - a thrombus overlying a plaque causes 75% of myocardial infarctions, with superficial plaque erosion present in the remaining 25%.
• Emboli - from left sided mural thrombosis, vegetative endocarditis, or paradoxic emboli from the right side of heart through a patent foramen ovale. ("The internet pathology," 2011)
Morphological changes
The molecular events during MI relate to the initial ischemic event, reperfusion, and subsequent inflammatory response. Up to 6 hours following the initial ischemic event, most cell loss occurs via apoptosis. After that, necrosis predominates. Ischemic endothelial cells express adhesion molecules that attract neutrophils that subsequently migrate into damaged myocardium.
Evolution of Morphologic Changes in Myocardial Infarction:
Time Gross Features Light Microscopic Findings

0-½ hr None ultra structural changes (reversible with reperfusion up to approximately 20 minutes ischemic time)

½-4hr None Usually none; variable waviness of fibers at border

4-12hr Occasionally dark mottling Beginning coagulation necrosis; edema; hemorrhage

12-24hr Dark mottling Ongoing coagulation necrosis; pyknosis of nuclei; marginal contraction band necrosis; beginning neutrophilic infiltrate

1-3 days Mottling with yellow-tan infarct center Coagulation necrosis, with loss of nuclei and striations; interstitial infiltrate of neutrophils

3-7 days Hyperemic border; central yellow-tan softening Beginning disintegration of dead myofibers, with dying neutrophils; early phagocytosis of dead cells by macrophages at infarct border

7-10 days Maximally yellow-tan and soft, with depressed red-tan margins Well-developed phagocytosis of dead cells; early formation of fibro-vascular granulation tissue at margins

10-14 days Red-gray depressed infarct borders Well-established granulation tissue with new blood vessels and collagen deposition

2-8wk Gray-white scar, progressive from...

Other Essays Like Pathology

Undertake Home Visits Within Pathology Essay

726 words - 3 pages Undertake Home Visits. Assessment. Mr John Hughes is an elderly man who lives alone and you are visiting him to perform a blood test. He is unwell after having a prolonged bout of Gastroenteritis. What precautions will you use when assisting Mr Hughes? Mr Hughes may still be slightly dehydrated or at a risk of fainting during the blood test so extra precautions should be taken. He may have difficult veins due to lack of dehydration as well

European Laboratory Information System (LIS) Market by Product

623 words - 3 pages ï»¿ Aarkstore : European Laboratory Information System (LIS) Market by Product (Integrated Laboratory Information System), by Type (Clinical Pathology Laboratory Information System, Anatomic Pathology Laboratory Information System) - Forecast to 2019 Summary The European laboratory information systems market is estimated to grow at a CAGR of 7.6% from 2014 to 2019. Germany holds a larger share of the

Type 1 Diabetes

1597 words - 7 pages Discuss the current knowledge of the contribution of cellular and molecular components of the immune system to the pathology of type 1 diabetes Abstract An autoimmune disease resulting in insulin deficiency, Type 1 diabetes mellitus. There have been countless studies into its causes; there is still no solid answer. Previous studies strongly implicated Th1 cells to play a key role in the progression of type 1 diabetes, however, recent studies

Clincial Assessment

586 words - 3 pages changed in any way. Assessment Tools After gathering all the important information from the parents I could determine a plan of approaching Clara and conversing with her. One form of assessment I would consider is the PAPA or Preschool Age Psychiatric Assessment. This assessment offers direct questioning of the foster parents in an effort to use diagnostic measures for the child’s pathology (Comer, 2006). This tool is appropriate in this case

The Pathway To Psychosis

1415 words - 6 pages allele (Stefanis, et al., 2007, p. 1651). Therefore, it is possible that the COMT Val158Met Val allele plays a part in stress-induced psychosis. Another study published in the Schizophrenia Bulletin entitled Developmental Pathology, Dopamine, and Stress: A Model for the Age of Onset of Schizophrenia Symptoms takes a biological approach to stress-induced psychosis. The study looks at Dopamine release in relation to

Income Tax Deductions

1758 words - 8 pages themselves with their respective step within the broad pattern, for best part does not fit in with the overall pathology. The American Revolution displayed that certain stages matched with the broad general pattern and throughout its duration exhibited characteristics and causes normally attributed to revolutions. Other parts of the Revolution however tended to deviate from the generally accepted pattern. As a prelude before the

The "Banking" Concept Of Education Excerpt From "Pedology Of The Oppressed" By Paulo Freire

493 words - 2 pages oppressed are adapted to the situation the easier they are to be dominated. The more we (oppressed) are "filled" the less likely we will ask why; the less the oppressed will be questioned. The oppressed are regarded as the pathology of "the healthy society" and are regarded as "incompent and lazy". Does that therefore mean we need to be cultivated and civilized by oppressors? By no means !The oppressed are a "threat" to our society because we are the

Ecosystemic Psychology

566 words - 3 pages seen as closed with intact boundaries where negative feedback may be defined. It can never be completely understood from another individual in an absolute truth. (2) How is health and pathology addressed by each approach? First order: Focuses on identifying and labelling the problem, that is, the patient as a system-maintaining part of the family. -Pathology is seen objectively outside as apart from the family. Second order: The internal

Social Issues Course, Obesity, 7 Sources

2136 words - 9 pages less body dissatisfaction, and report engaging in more appearance-change behaviors (specifically, behaviors having to do with exercise and muscle building). Men who reported receiving negative commentary were more likely to experience eating pathology and body dissatisfaction and report more dieting, hair-related, and genital focused behaviors. It appears that men are affected by negative, appearance-related commentary in a similar fashion as

Peace Agency

1252 words - 6 pages | |[pic] | |Melissa Conrad Stöppler, MD | |Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of | |Experimental and Molecular Pathology. Dr

ANTHRAX-Weapon Of Mass Destruction

396 words - 2 pages anthrax were very large, Gram-positive, and spore-forming rod shaped. It can survive in aerobic or anaerobic conditions. It is very similar genotypically and phenotypically to Bacillus cereus and bacillus thuringiensis.The pathology of anthrax can come in 3 different forms: Cutaneous, Gastrointestinal, and Inhalation. Cutaneous is the least deadly form of anthrax. This form is contracted through the skin. It is not very serious, affecting humans

Related Papers

Pathology Paper

3368 words - 14 pages be related to his current problems and medication side effects. The preexisting conditions of cardiomyopathy, hypertension, sinus tachycardia will then be related to the gastrointestinal bleed caused by the ulcer and the medical intensive care unit admission of volume deficit along with his linking his previous conditions to his current medical state. Pathology of First Admitting Problem The information and medical facts in this section will

Pathology Signs And Symptoms Essay

729 words - 3 pages Pathology Signs and Symptoms Absence Seizure-Type of epileptic seizure that lasts only a few seconds to half a minute, characterized by a loss of awareness and an absence of activity. It is also called petit mal seizure. Anesthesia-Lack of feeling or sensation Aura-Sensations, such as seeing colors or smelling an unusual odor, that occur just prior to an epileptic seizure or migraine headache. Coma-Profound unconsciousness resulting from an

Cystic Fibarosis Pathology Paper

663 words - 3 pages Cystic fibrosis is an autosomal recessive disorder that affects the function of the exocrine glands in multiple organ systems, mainly resulting in chronic respiratory infections and insufficient pancreatic enzymes. Cystic fibrosis is caused by mutations of two gene pairs, one from mom and one from dad, on chromosome 7. However, if the person inherits mutations on just one gene they don’t actually have the disease but they are a carrier of Cystic

Use Of Evidenced Based Practice In The Field Of Speech Language Pathology

1328 words - 6 pages in the field of Speech-Language Pathology. Worrall and Bennet discussed several potential barriers to EBP that might affect speech-language pathologists. These barriers include: databases that lack critical journals from the field of communication disorders, a lack of evidence or high-level evidence in specific areas, mismatches between evidence and the reality of clinical services, and the lack of a database of critically appraised topics in