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→Virtual Microscopy
File:IPLab4MuralThrombus7.jpg|This high-power photomicrograph of thrombus demonstrates more clearly the components of the layers--the pale regions which contain primarily platelets (degranulated platelets) with some fibrin (1), and the red areas which contain RBCs, some leukocytes, and fibrin (2).
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== Virtual Microscopy ==
=== Heart:Mural Thrombus ===
<peir-vm>IPLab4MuralThrombus</peir-vm>
=== Normal Heart ===
<peir-vm>IPLab2Hypertrophy_normal_Heart</peir-vm>
== Study Questions ==
* <spoiler text="Why do mural thrombi form on the endocardium of the heart after a myocardial infarction?">The infarct produced necrosis and inflammation. Also, the infarcted ventricular wall is akinetic and/or dyskinetic (bulges outward during systole). Thus, the blood in the ventricle tends to form thrombi on the surface of the infarcted endocardium.</spoiler>
* <spoiler text="List the sequence of events leading to mural thrombus formation.">* Platelets bind to damage endocardium and release ADP, 5-HT, thromboxane and platelet factor 4.
* This results in recruitment of more platelets and more degranulation of platelets with activation of the clotting cascade.
* Thrombin is activated leading to fibrin polymerization.
* This process results in the development of a platelet-fibrin thrombus.</spoiler>
* <spoiler text="What are possible sequelae of these mural thrombi?">The thrombotic material may break off and go to the brain or kidney (the two most likely sites since they get so much blood flow) or any arterial system.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/1950759-overview eMedicine Medical Library: Noncoronary Atherosclerosis]
* [http://emedicine.medscape.com/article/155919-overview eMedicine Medical Library: Myocardial Infarction]
* [http://www.merckmanuals.com/professional/hematology_and_oncology/thrombotic_disorders/thrombotic_disorders.html Merck Manual: Thrombotic Disorders]
* [http://www.merckmanuals.com/professional/cardiovascular_disorders/coronary_artery_disease/acute_coronary_syndromes_acs.html Merck Manual: Acute Coronary Syndromes (ACS)]
=== Journal Articles ===
* Diop D, Aghababian RV. [http://www.ncbi.nlm.nih.gov/pubmed/11373977 Definition, classification, and pathophysiology of acute coronary ischemic syndromes]. ''Emerg Med Clin North Am'' 2001 May;19(2):259-67.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/424-mural_thrombus PEIR Digital Library: Mural Thrombus Images]
* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#3 WebPath: Myocardial Infarction]
* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#2 WebPath: Atherosclerotic Cardiovascular Disease]
== Related IPLab Cases ==
* [[IPLab:Lab 1:Myocardial Infarction|Lab 1: Heart: Myocardial Infarction (Coagulative Necrosis)]]
* [[IPLab:Lab 3:Acute Myocardial Infarction|Lab 3: Heart: Acute Myocardial Infarction]]
* [[IPLab:Lab 3:Healed Myocardial Infarction|Lab 3: Heart: Healed Myocardial Infarction]]
* [[IPLab:Lab 4:Thrombosis|Lab 4: Coronary Artery: Thrombosis]]
* [[IPLab:Lab 4:Pulmonary Congestion and Edema|Lab 4: Lung: Pulmonary Congestion and Edema]]
{{IPLab 4}}
[[Category: IPLab:Lab 4]]