The myocardial lesion

In human infarction the occlusion can be sudden and persistent, but it is often slower in onset with intermittent occlusion occurring over some hours or even days. Mural thrombus is associated with platelet emboli and causes focal microscopic foci of necrosis of differing ages. These different mechanisms lead to considerable variation in the structure of human infarcts ( Fig 2). The simplest form is a transmural infarct in which the tissue necrosis is uniform in age. Such infarcts are often associated with the appearance of Q waves in the ECG and have potentially serious consequences such as rupture. egional infarcts are also formed by the coalescence of focal areas of necrosis of widely differing ages; such infarcts are more likely to be confined to the inner zone of the myocardium (non-transmural) and may not have Q waves.

Fig. 2 Stages and factors influencing coronary thrombosis.

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