[Morphology of acute myocardial infarction at prenecrotic stage]

Area of Science:

• Cardiology
• Pathology
• Biochemistry

Background:

• Sudden cardiac death (SCD) is a critical medical emergency.
• Myocardial infarction (MI) is a leading cause of SCD.
• Understanding pre-necrotic stages of MI is crucial for intervention.

Purpose of the Study:

• To investigate morphological changes in the myocardium during the pre-necrotic stage of myocardial infarction.
• To analyze the content of glucose, potassium, calcium, and sodium in pericardial fluid in cases of sudden cardiac death due to pre-necrotic MI.
• To differentiate between morphological forms of pre-necrotic myocardial infarction and their implications.

Main Methods:

• Histopathological examination of myocardial tissue.
• Biochemical analysis of pericardial fluid for electrolytes (glucose, potassium, calcium, sodium).
• Correlation of morphological findings with clinical outcomes (sudden death).

Main Results:

• Acute myocardial infarction at the pre-necrotic stage exhibits two distinct morphological forms: transmural or subendocardial/epicardial localization of ischemic injury.
• Transmural injury involves extensive left ventricular damage, generalized coronary arterial spasm, and cardiomyocyte dysfunction.
• Localized ischemic injury shows alternating foci of ischemia and normal blood supply, with similar rheological disturbances and ventricular fibrillation markers compared to transmural MI.

Conclusions:

• Pre-necrotic myocardial infarction can manifest as transmural or localized ischemic patterns.
• Both forms share disturbances in blood rheology and markers of ventricular fibrillation, increasing necrosis and arrhythmia risk.
• These findings highlight the importance of early detection and management of pre-necrotic MI to prevent sudden cardiac death.