MI light microscopy changes

[mlw03]

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So this is for the residents or others who have some real experience looking at post-MI myocardium. If a patient died 3 hours after an MI, could an experienced pathologist see myocardial changes at the light microscopy level? Robbins (7th ed) is kinda vague about this. On pg 579 a table says "usually none", but a figure on pg 581 puts the beginnings of coagulation necrosis right around the 3-3.5 hour mark. So I'll be curious to hear what those of ya'll with experience at this have to say on the topic.

 

[yaah]

Well, I had one where we could pinpoint the thrombotic event to 2 hours prior to death and we saw nothing. Personally, I think it would be debatable, the most you would see would be some contraction bands or wavy fibers which are kind of non specific and seen in lots of deaths regardless of recent MI or not. Some people use tetrazolium or something like that but I have never seen it. I think, also, if you have a large infarct the changes may be even slower to show up, like 5-6 hours.

You would be more likely to see the thrombus and that would help you out. And three hours is often enough time to have enough clinical data.

 

[Cabbage Head]

Microscopically, you might see an infiltration of polys, or even just polys starting to demarginate. You'll see that before myocyte changes, and it's less subjective than "wavy fibers" I think. But probably not at 3 hours.

 

[djmd]

Microscopically, you might see an infiltration of polys, or even just polys starting to demarginate. You'll see that before myocyte changes, and it's less subjective than "wavy fibers" I think. But probably not at 3 hours.

You might find the polys at 3 hours, (be sure to check the papillaries..)

Nice Avatar CabbageHead, KiTH rock.
😀 It's a Fact.

 

[Adolf]

So this is for the residents or others who have some real experience looking at post-MI myocardium. If a patient died 3 hours after an MI, could an experienced pathologist see myocardial changes at the light microscopy level? Robbins (7th ed) is kinda vague about this. On pg 579 a table says "usually none", but a figure on pg 581 puts the beginnings of coagulation necrosis right around the 3-3.5 hour mark. So I'll be curious to hear what those of ya'll with experience at this have to say on the topic.

immunio staining with fibronectin my come in handy. P-selectin on vessels endothelium can also do.