[Pathomorphological changes in the myocardium outside of the infarct area in the postresuscitation period...

The results of clinico-morphological and electron microscopic examinations of the myocardium outside the infarction zone (73 observations) are presented. The dependence of the alterations on the extent of hemodynamic disorders and on the mechanism of the heart activity arrest was taken into account. In 12 cases repeated heart defibrillation (up to 110 seanses) was applied. In progressive cardiac insufficiency, myocardium outside the infarction zone exhibits disseminated vascular lesions with severe rheological disorders of the blood and development of numerous damages of the contractile myocardium. These changes are less marked in "sudden" death with myocardial infarction. The authors believe that heart fibrillation is structurally reflected in fragmentation of the muscle fibers in the mechanism of the development of which an important role is also played by myocardial ischemia. The authors distinguish two types of myocardium fragmentation: diffuse and focal, the functional importance of which is different. Multiple defibrillations of the heart do not cause severe structural changes in the myocardium.