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The Coronary Arteries: Atherosclerosis and Ischaemic Heart Disease
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Pathologically, MI develops 12 to 24 hours after onset of ischaemia, is easily detected with standard haematoxylin and eosin (H&E) staining, and is mainly characterized by the myocardial infiltration of polymorphonuclear granulocytes. Diagnosing early myocardial ischaemia is challenging because the associated histopathological lesions are either nonspecific or controversial, such as myofiber hypereosinophilia, wavy fibres, interstitial oedema, nuclear alterations, and contraction band necrosis (also known as coagulative myocytolysis), with or without interstitial haemorrhage. The wavy fibres alone do not have a diagnostic value because of their nonspecificity. Contraction band necrosis is considered by some pathologists as a sign of ischaemia when regional and by others as a histological hallmark of adrenergic stress, reperfusion injury, or an agonal artifact when diffuse.
The cardiovascular system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Mary N Sheppard, C. Simon Herrington
Some contraction bands will be found in any heart that has gone into ventricular fibrillation (VF) before death. If, however, they are present in large numbers, and in particular if they are found in one region only, they are a reliable means of identifying early infarction. Even when reperfusion had not occurred, some contraction band necrosis is usually found at the edge of an infarct that predominantly shows the colliquative pattern of necrosis. Contraction band necrosis has also been called coagulative myocytolysis.
Ischemic Heart Disease
Published in P. Chopra, R. Ray, A. Saxena, Illustrated Textbook of Cardiovascular Pathology, 2013
Besides the typical coagulative necrosis which is pathognomonic of acute myocardial infarction, another type of ischemic change known as colliquative necrosis or myocytolysis can be seen in ischemic myocardium (Figs 6.17a and b). This change is seen in the myocytes in the subendocardium. These cells though viable suffer chronic ischemia. The cells appear large, vacuolated with intact nuclei. Ultrastructurally loss of myofibers is the predominant change. This change represents hibernation of myocardium which can resume function on appropriate reperfusion. Contraction band necrosis occurs in reperfusion injury (described later).
Morphological changes without histological myocarditis in hearts of COVID-19 deceased patients
Published in Scandinavian Cardiovascular Journal, 2022
Ali Razaghi, Attila Szakos, Riham Al-Shakarji, Mikael Björnstedt, Laszlo Szekely
The waviness of myocytes occurs when the isolated contractility of myocytes is lost but the neighboring fibers are still contracting. The waviness of myocytes is demonstrated by myofibrils narrowing and becoming wavy. Over 90% of the cases showed the presence of wavy cardiocytes in at least one of the histological samples. Fibrosis was seen as a clear sign of old infarction where the dead heart muscle cells are replaced by collagen-rich connective tissue. Remenants of old infarct in form of fibrosis were detected only in the three cases with AMI due to coronary occlusion (Figure 1(A)). Contraction band necrosis often occurs as a myocardial injury at a site of reperfusion when oxygen-rich blood returns to the ischemic area, typically at the edge of the infarcted area.
Complete atrioventricular block in a patient with systemic sclerosis
Published in Scandinavian Journal of Rheumatology, 2019
Bulkley et al reported the presence of contraction-band necrosis, which is a histological lesion seen in the setting of reperfusion injury, and found that this lesion may be correlated with the extent of fibrosis (6). A clinical physiological study by Follansbee et al supported this notion, indicating that a disturbance of the myocardial microcirculation may lead to fixed and reversible abnormalities of myocardial perfusion resulting in cardiac fibrosis (7). Another study indicated that lesions of the small coronary arteries are important as a basis for fibrotic and degenerative changes throughout the myocardium and conduction system (8).
Understanding left ventricular hypertrabeculation/noncompaction: pathomorphologic findings and prognostic impact of neuromuscular comorbidities
Published in Expert Review of Cardiovascular Therapy, 2019
Claudia Stöllberger, Josef Finsterer
Contraction band necrosis of cardiomyocytes was found in three cases, all of them underwent cardiac resuscitation [144–146]. Up to now the pathogenesis of contraction band necrosis is assessed controversially and recently it has been suggested that contraction band necrosis after resuscitation is caused by the cardiac massage itself, and that most resuscitation-induced contraction bands are not contraction band necrosis but rather artefactual contraction bands [147].