INFARCTION

INFARCTION
Definition :
area of ischemic necrosis caused by 40% of all deaths in the
occlusion of the arterial supply or United States are caused
the venous drainage by cardiovascular disease,

Causes of infarction :
1-Thrombi and emboli ( most common )
2-Local spasm of the artery or torsion of vessels
3-Extrinsic compression of vessel by tumor
4-Rupture of the artery
Types of infarction
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COLOUR Presence or absence of infection

Pale Red: Septic:

Occur : in solid organs - Occur: in double circulation Aseptic: when there is
Due to : arterial occlusion - Due to : venous occlusion. free of infarction infection
Example : heart spleen ,kidney - Example: Lung & small intestine
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PATHOGENESIS : Rate of development of occlusion:
❖ Local anoxemic occurs after obstruction of the blood supply. ❖ Slowly developing occlusions are less to cause infarction
❖ Within few hours the affected part becomes swollen due to edema
and hemorrhage. Because it provide time for development pathways of flow
❖ being more marked in the lungs , and less extensive in the kidneys (collateral circulation)
and heart. ❖ Example: Coronary arteries
❖ Cellular changes such as swelling and degeneration appears early,
❖ death of the cells or necrosis occurs in 12-48 hours
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❖ The availability of blood supply is the most factor determining
occlusion of a vessel will cause damage.
Vulnerability of hypoxia :
DEF : The susceptibility of a tissue to hypoxia influenced the
❖ Examples: Lung , Liver likelihood of infarction
❖ Both have dual circulation Examples:
❖ Therefor obstruction of small arteriole does not cause infarction 1) Neurons irreversible damage
2) Myocardial cell die after only 20-30 min
3) Skeletal muscles can survive longer time
 Pathologic Changes:
❖ infarcts of solid organs :
1) wedge-shaped apex
2) pointing towards occluded artery wide base
3) on the surface of the organ.

❖ Most infarcts become :

1) pale because the red cell are lysed
2) pulmonary infarcts never become pale due to extensive amount of blood.

❖ Infarcts due to :
1) Arterial occlusion
2) pale
3) Venous obstruction
3) hemorrhagic.

Microscopically :
❖ The pathognomic change in all infarcts is coagulative (ischaemic) necrosis of the affected
area of tissue or organ.

❖ In cerebral infarcts:
characteristic liquefactive necrosis.

inflammatory reaction is noted.

first

Initially neutrophils predominate ,later macrophages and fibroblasts

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appear.
Finally
Eventually, necrotic area is replaced by fibrous scar.
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In cerebral infarcts, the liquefactive necrosis is followed by gliosis.