Acute subepicardial infarction associated with severe septic shock – insight in myocardial perfusion
| Autor: | Annette M. May, Ursus-Nikolaus Riede, Florian N. Riede |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Infarction Pericardial effusion Pathology and Forensic Medicine Fatal Outcome Streptococcal Infections Internal medicine medicine Humans Lung Abscess cardiovascular diseases Myocardial infarction Pleurisy Aorta Endocardium business.industry Myocardium Electrocardiography in myocardial infarction Pneumonia Cell Biology Disseminated Intravascular Coagulation Middle Aged medicine.disease Coronary Vessels Shock Septic Leriche Syndrome Shock (circulatory) Heart failure Hypertension cardiovascular system Cardiology Myocardial infarction complications Streptococcus intermedius medicine.symptom business |
| Zdroj: | Pathology - Research and Practice. 206:401-404 |
| ISSN: | 0344-0338 |
| DOI: | 10.1016/j.prp.2009.11.001 |
| Popis: | Isolated infarctions of the subepicardial myocardium without changes in subendocardium are extremely rare. We present an autoptic case with an acute subepicardial infarction of the right- and left-ventricular myocardium. A 53-year-old male was admitted to hospital with acute upper abdominal pain. Clinical examination revealed an acute infero-lateral myocardial infarction. The patient succumbed to acute heart failure a few hours later. Autopsy revealed numerous pulmonary abscesses due to suppurative lobular pneumonia with consecutive pericardial effusion. Furthermore, we diagnosed an acute myocardial infarct encompassing the entire right and left ventricles but limited to the subepicardial myocardium only. Microscopically, we observed fibrin microemboli in the subepicardial microvessels. The existence of an isolated subepicardial myocardial infarct challenges our understanding of myocardial perfusion. |
| Databáze: | OpenAIRE |
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