PRACTICA II

CARDIOVASCULAR
CAROLINA DEL PILAR BARRIENTOS SAAVEDRA
VICTOR DANIEL LINARES BACA
LUCIANA ELCIRA BARTUREN MONDRAGON
FISIOPATOLOGÍA, SEMIOLOGÍA Y ANATOMÍA PATOLÓGICA
2021- I
Recent myocardial infarct (first 24 hours) (detail). (H&E, ob. x20)
This high power microscopic view of the myocardium demonstrates an infarction of about 1 to 2 days in
duration. The myocardial cell nuclei have almost all disappeared. There is beginning acute inflammation.
Clinically, such an acute myocardial infarction is marked by changes in the electrocardiogram and by a rise
in the MB fraction of creatine kinase.
IM
 Fibras musculares
muertas no
contráctiles que
las estiran y
ondulan

The earliest change histologically seen with acute myocardial infarction in the first day is contraction band necrosis. The
myocardial fibers are beginning to lose cross striations and the nuclei are not clearly visible in most of the cells seen here.
Note the many irregular darker pink wavy contraction bands extending across the fibers.
Myocardial infarct - circumscribed area of ischemic necrosis - coagulative necrosis. In the first 12 - 24 hours, myocardial fibers are still well delineated, with intense
eosinophilic (pink) cytoplasm, but lost their transversal striations and the nucleus (left side of the picture). Notice a few myocardial fibers showing hypertrophy (increased
size of the fiber, irregular shape of the nuclei). (H&E, ob. x20)
This myocardial infarction is about 3 to 4 days old. There is an extensive acute inflammatory
cell infiltrate and the myocardial fibers are so necrotic that the outlines of them are only
barely visible.
This is an intermediate myocardial infarction of 1 to 2 weeks in age. Note that there are
remaining normal myocardial fibers at the top. Below these fibers are many macrophages
along with numerous capillaries and little collagenization.
 DERRAME
PERICARDICO
Este es un ejemplo
de una pericarditis
fibrinosa .

La superficie rugosa
aparece a partir de la
apariencia normal
reluciente por las
hebras de fibrina
rosa - bronceado.
Pericarditis fibrinosa
Tuberculous pericarditis
TRASTORNOS
VALVULARES
Calcific aortic
stenosis
occurring on a
congenitally
bicuspid valve.
One cusp has a
partial fusion at
its center, called
a raphe (arrow).
Degeneración mixomatosa de
la válvula mitral
(prolapso de la válvula mitral)
El cambio esencial es la
atenuación de la capa
fibrosa de la válvula de
la que depende la
integridad estructural de
la valva acompañada de
engrosamiento focal
marcado de la capa
esponjosa con deposito
de material mucoide
(mixomatoso).
 Fiebre reumática y
Cardiopatía reumática
Células de anitschkow tienen citoplasma abundante y núcleo central entre
redondo y oval, con la cromatina dispuesta en forma de cinta ondulada delicada
(“células en oruga”)
Células en
oruga
La afectación
simultanea del
endocardio y las
válvulas del lado
izquierdo por focos
inflamatorios
conduce en los casos
típicos a necrosis
fibrinoide dentro de
las cúspides o a lo
largo de las cuerdas
tendinosas sobre las
que se asientan
vegetaciones
(precipitación de
fibrina en sitios de
erosión)
Endocarditis
Infecciosa
A mitral valve vegetation caused by bacterial endocarditis.
A vegetation arisen from valve; note myocardium in the left lower corner.
Pinkish stained vegetation with minimal inflammation; note densely inflammatory
infiltrate in the valve leaflet.