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Infarction
CONTENTS:
Definition
Etiology
Types
Pathogenesis
Pathologic changes
Infarcts of different organs
References
DEFINITION:
Localized area of ischemic necrosis in an
organ or tissue resulting most often from
reduction of arterial blood supply or
occasionally its venous
drainage………………….ROBBINS
ETIOLOGY:
•Most Commonly, Infarcts are caused by
Interruption in arterial blood supply, called
ischemic necrosis
•Less commonly, Venous obstruction can
produce infarcts termed stagnant hypoxia. 
•Generally , Sudden, complete and
continuous occlusion by thrombosis or
embolism
•Torsion of a vessel, e.g. in testicular torsion
•Traumatic rupture or vascular compromise by
edema, e.g. anterior compartment syndrome.
• No occlusive circulatory insufficiency
TYPES:
•COLOUR
a.Red or hemorrhagic
b.Pale or anemic
•Depending on Age
 

a.Recent or fresh.
b.Old or healed.
•Presence or absence of infection.
a.Bland – when free of bacterial
contamination
b.Septic – when infected.
 Localized
PATHOGENESIS: hyperemia Edema
and hemorrhage

Cellular
changes

Progressive An acute
proteolysis of inflammatory
necrotic tissue and reaction and
lysis of red cells hyperaemia

Blood pigments
liberated by hemolysis
Progressive ingrowth
of granulation tissue
  PATHOLOGICAL CHANGES:
•Grossly, infarcts of solid organs -wedge-
shaped
• apex -pointing towards occluded artery wide
base - on the surface of the organ. •Infarcts due
to arterial occlusion -pale venous obstruction -
hemorrhagic.
•Most infarcts become pale later as the red cell
are lysed but pulmonary infarcts never become
pale due to extensive amount of blood
Cerebral infarcts:
Poorly defined with central softening
(encephalomalacia).
Recent infarcts :
slightly elevated over the surface
Old infarcts :
shrunken , depressed under the surface of
the organ.
INFARCTS OF DIFFERENT ORGANS
LUNG INFARCTION:
Embolism of the pulmonary arteries
• May occur in patients who have inadequate
circulation : Chronic lung diseases
• Congestive heart failure.
 KIDNEY INFARCTION:
Renal infarcts are Common caused by
Thromboemboli most commonly originating
from heart such as mural thrombi in the left
atrium ,MI,Vegetative endocarditis Less
commonly renal artery atherosclerosis, arteritis
sickle cell anemia
 INFARCT SPLEEN:
•Common site for infarcts
•It results from Occlusion of one of the
splenic arteries or its branches.
Most common cause : thromboemboli
arising in heart (eg.mural thrombi in the left
atrium vegetative endocarditis myocarditis
myocardial infarction)
INFARCT LIVER:
• Uncommon
• Dual blood supply
•Obstruction of the portal vein is usually
secondary to other diseases : Hepatic
cirrhosis, IV invasion of primary CA of
liver, CA of pancreas • Generally does not
produce ischemic infarction but instead
reduced blood supply to hepatic
parenchyma causes non-ischemic infarct
called infarct of Zahn.
 CEREBRAL INFARCTION:
•Local vascular occlusion
•Occasionally, non-occlusive cause
compression of the cerebral arteries from
outside and from hypoxic encephalopathy
•Clinically, the signs and symptoms depend
upon the region infarcted.
•In general, the focal neurologic deficit termed
stroke, is present.
•However, significant atherosclerotic
cerebrovascular disease may produce
transient ischemic attacks (TIA).
MYOCARDIAL INFARCTION:
 Most Important consequence of
coronary artery disease
 Patient may die within first few hours of
the onset while remainder suffer from
effects of cardiac function
 INCIDENCE: Occurs at all age but more
common in elderly
LOCATION OF INFARCTS:
• LV
•RV is less susceptible , due to its thin wall,
having less metabolic requirements and is
thus adequately nourished
•Atrial infarcts, whenever usually accompany
infarct of LV
•LA is relatively protected because it is
supplied by oxygenated blood in the left atrial
chamber.
REGION OF INFARCTION:
Area of obstructed blood supply by one or
more of three coronary arterial trunks in
descending order:
1.Left anterior descending coronary artery :40
to 50%
2.Right coronary artery :30 to 40% 3.Left
circumflex coronary artery:15 to 20%
Regions of myocardial infraction.
Stenosis of the left anterior descending
coronary artery is the most common (40-
50%).
 Region of infarction in the anterior part of
the left ventricle including the apex and the
anterior two-thirds of the interventricular
septum
REFERENCES:
1.Robbins and Cotran - Pathologic basis of
diseases. 8th edition.
2. Harsh Mohan – Text book of pathology.
3rd edition.
3.Mc Gee, Isaacson and Wright – Oxford text
book of Pathology. Principles of Pathology
volume 1.
4.Anderson’s Pathology – 10th edition
God gave us healing hands ..…….
To heal the wounds of the world