ST elevation myocardial infarction gross pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Cafer Zorkun, M.D., Ph.D. [2]

## Gross Pathology

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Myocardial infarction can be classified temporally from clinical and other features, as well as according to the pathological appearance as:[1]

* Evolving phase of myocardial infarction: (>6 hours),
* Acute phase of myocardial infarction: (6 hours – 7 days),
* Healing phase of myocardial infarction: (7–28 days),
* Healed phase of myocardial infarction: (29 days and beyond).

Time from Onset and Gross Morphologic Finding Relations:

* 18 - 24 hours: Pallor of myocardium
* 24 - 72 hours: Pallor with some hyperemia
* 3 - 7 days: Hyperemic border with central yellowing
* 10 - 21 days: Maximally yellow and soft with vascular margins
* 7 weeks: White fibrosis

### Images

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Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Acute Myocardial infarction. | Myocardial infarction, fibrosis. Right Coronary Artery's territory.

Acute Myocardial infarction; Posterior wall. | Gross example of myocardial infarction that is several weeks or perhaps months of age.

Acute myocardial infarction. Multi sliced view. | Gross example of acute infarction in fixed heart. Lesion is reflow necrosis stone heart also has old scar. Multisliced view.

Old myocardial infarction with fibrosis and apical thrombus. | Old myocardial infarction with fibrosis.

Acute myocardial infarction with epicardial fibrin. | Myocardial infarction and rupture.

Myocardial infarction; free wall, 6 days old, in a patient with diabetes mellitus and hypertension. | Myocardial infarction free wall, 6 days old, in a patient with diabetes mellitus and hypertension.

Anterior surface of the heart in patient with acute posterior myocardial infarction. | Posterior surface of the heart in patient with acute posterior myocardial infarction.

Old myocardial infarction with aneurysm formation | Myocardial Infarction: Gross; Left ventricle; a mural thrombus.

Myocardial Infarction: Gross; An excellent example of all ventricular slices in case of healing posterior and healed anterior myocardial infarction. A mural thrombus at apex. | Myocardial Infarction: Gross; A ventricular slice near apex; Large old anterior and posterior transmural infarctions with mural thrombosis.

Myocardial Infarction: Gross; External view showing indented area represent small posterior wall aneurysm.  | Myocardial Infarction: Gross; close-up view of anterior wall of left ventricle with dimpling due to aneurysm. Surrounding hyperemia indicates acute infarction.

Myocardial Infarction: Gross; healed lesion with mural thrombus (an excellent example) | Myocardial Infarct Scar: Gross; natural color; very large old anterior infarct with wall thinning, mild aneurysm and endocardial thickening. A typical lesion.

## References

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1. ↑ Thygesen K, Alpert JS, White HD; et al. (2007). "Universal definition of myocardial infarction". Circulation. 116 (22): 2634–53. doi:10.1161/CIRCULATIONAHA.107.187397. PMID 17951284. Unknown parameter `|month=` ignored (help)CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

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