Pathomorphology of postinfarction myocardial ischemia during atherosclerotic obstruction of coronary arteries.
Pathomorphological criteria of early postinfarction angina included segmentary atherosclerotic obstruction of the upper segments of the coronary artery supplying the infarction area, recurrent acute myocardial infarction, maximum decrease in vascularization of the left posterior ventricular wall; and individual changes in angioarchitectonics of the heart promoting hibernation of the myocardium. Pathognomonic morphological criteria of silent postinfarction myocardial ischemia included diffuse extensive atherosclerotic obstruction of lower segments in the coronary artery supplying the infarction area and total hypervascularization of the myocardium, first acute myocardial infarction of the left ventricular anterior wall, and maximum decrease in vascularization of the anterior and posterior wall in the left ventricle. These coronary-myocardial relationships contribute to stunning of the myocardium. Zones of hypokinesia and akinesia were revealed in the left ventricle, which reflects the phenomenon of resting myocardium associated with isolation of heart angioarchitectonics.
Rozenberg
V D
VD
Department of General Pathology and Pathomorphology, Institute of Regional Pathology and Pathomorphology, Siberian Division of the Russian Academy of Medical Sciences, Novosibirsk.
Nepomnyashchikh
L M
LM
D000787:Angina Pectoris / Q000150:complications; D003251:Constriction, Pathologic / Q000473:pathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology; D017202:Myocardial Ischemia; D017682:Myocardial Stunning; D009206:Myocardium / Q000473:pathology