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IPLab:Lab 3:Acute Myocardial Infarction

1,358 bytes added, 19:45, 17 September 2015
Virtual Microscopy
# Aspartate Aminotransferase (AST) 60 IU/L.
# Total Creatine Phosphokinase (CPK) 165 IU/L. All of the activity was due to CPK III (MM) isoenzyme fraction; no CPK (MB) activity was detectable.
# Lactic Dehydrogenase (LDH) 720 IUTroponin I 38 µg/L. LD1 fraction was greater than LD2.
== Autopsy Findings ==
File:IPLab3AcuteMyocardialInfarction7.jpg|This is a photomicrograph of the lines of Zahn. Pale areas (1) represent platelets with some fibrin and the darker lines (2) represent RBCs and leukocytes enmeshed in fibrin strands.
</gallery>
 
== Virtual Microscopy ==
=== Heart: Acute Myocardial Infarction ===
<peir-vm>IPLab3AcuteMyocardialInfarction</peir-vm>
 
=== Normal Heart ===
<peir-vm>IPLab2Hypertrophy_normal_Heart</peir-vm>
== Study Questions ==
* <spoiler text="Why do mural thrombi often form in infarcted hearts?">The endocardium is usually the most severely damaged after an arterial occlusion since it is at the end of the circulation of the heart. Thus, with the infarcted tissue in the endocardium there is an acute inflammatory reaction which initiates coagulation and thrombus formation.</spoiler>
* <spoiler text="What is the primary cell type in this inflammatory reaction?">At this stage it is primarily neutrophils, but there area a few macrophages. Usually, neutrophils enter an infarct by 12-24 hours and macrophages enter the lesion by 72 hours post-MI. By 3-7 days the lesion is primarily macrophages and by 10 days there are macrophages, fibroblasts, and endothelial cells (granulation tissue). The healing reaction in this patient may have been slower than normal because of his poor condition.</spoiler>
 
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/155919-overview eMedicine Medical Library: Myocardial Infarction]
* [http://www.merckmanuals.com/professional/cardiovascular_disorders/coronary_artery_disease/acute_coronary_syndromes_acs.html Merck Manual: Acute Coronary Syndromes]
 
=== Journal Articles ===
* Helft G, Worthley SG. [http://www.ncbi.nlm.nih.gov/pubmed/16352041 Anti-thrombotic, anti-platelet and fibrinolytic therapy: current management of acute myocardial infarction]. ''Heart Lung Circ'' 2001;10(2):68-74.
 
=== Images ===
* [{{SERVER}}/library/index.php?/tags/43-myocardial_infarct PEIR Digital Library: Myocardial Infarct Images]
* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html WebPath: Cardiovascular Pathology]
 
== Related IPLab Cases ==
* [[IPLab:Lab 1:Myocardial Infarction|Lab 1: Heart: Myocardial Infarction (Coagulative Necrosis)]]
* [[IPLab:Lab 3:Healed Myocardial Infarction|Lab 3: Heart: Healed Myocardial Infarction]]
* [[IPLab:Lab 4:Mural Thrombus|Lab 4: Heart: Mural Thrombus]]
* [[IPLab:Lab 4:Thrombosis|Lab 4: Coronary Artery: Thrombosis]]
* [[IPLab:Lab 4:Pulmonary Congestion and Edema|Lab 4: Lung: Pulmonary Congestion and Edema]]
{{IPLab 3}}
[[Category: IPLab:Lab 3]]