Infarction

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Template:Short description Template:Distinguish Template:Infobox medical condition (new)

Infarction is tissue death (necrosis) due to inadequate blood supply to the affected area. It may be caused by artery blockages, rupture, mechanical compression, or vasoconstriction.<ref>Template:Cite web</ref> The resulting lesion is referred to as an infarct<ref>Template:Cite web Citing:

  • The American Heritage Dictionary of the English Language, Fourth Edition. Updated in 2009.
  • The American Heritage Science Dictionary 2005 by Houghton Mifflin Company.

</ref><ref>Template:Cite web</ref> (from the Latin infarctus, "stuffed into").<ref>Template:Cite web</ref>

Causes

Template:Unreferenced section Infarction occurs as a result of prolonged ischemia, which is the insufficient supply of oxygen and nutrition to an area of tissue due to a disruption in blood supply.<ref>Template:Cite journal</ref> The blood vessel supplying the affected area of tissue may be blocked due to an obstruction in the vessel (e.g., an arterial embolus, thrombus, or atherosclerotic plaque), compressed by something outside of the vessel causing it to narrow (e.g., tumor, volvulus, or hernia), ruptured by trauma causing a loss of blood pressure downstream of the rupture, or vasoconstricted, which is the narrowing of the blood vessel by contraction of the muscle wall rather than an external force (e.g., cocaine vasoconstriction leading to myocardial infarction).Template:Fact

File:Atherosclerosis timeline - endothelial dysfunction.svg
Infarction could be caused by damaged cholesterol plaque

Hypertension and atherosclerosis are risk factors for both atherosclerotic plaques and thromboembolism. In atherosclerotic formations, a plaque develops under a fibrous cap. When the fibrous cap is degraded by metalloproteinases released from macrophages or by intravascular shear force from blood flow, subendothelial thrombogenic material (extracellular matrix) is exposed to circulating platelets and thrombus formation occurs on the vessel wall occluding blood flow. Occasionally, the plaque may rupture and form an embolus which travels with the blood-flow downstream to where the vessel narrows and eventually clogs the vessel lumen.

Classification

File:InfarctPandLbasilarsegmentsPE.PNG
Infarction of the lung due to a pulmonary embolism

By histopathology

File:Thrombosis.png
A blood clot could be a broken thrombosis that got clotted to the blood vessel wall.

Infarctions are divided into two types according to the amount of blood present:

  1. White infarctions (anemic infarcts) affect solid organs such as the spleen, heart and kidneys wherein the solidity of the tissue substantially limits the amount of nutrients (blood/oxygen/glucose/fuel) that can flow into the area of ischaemic necrosis. Similar occlusion to blood flow and consequent necrosis can occur as a result of severe vasoconstriction as illustrated in severe Raynaud's phenomenon that can lead to irreversible gangrene.
  2. Red infarctions (hemorrhagic infarcts) generally affect the lungs or other loose organs (testis, ovary, small intestines). The occlusion consists more of red blood cells and fibrin strands. Characteristics of red infarcts include:

Template:Cite journal </ref> such as myocardial infarction, stroke (cerebral infarction), shock-resuscitation, replantation surgery, frostbite, burns, and organ transplantation.

File:Hemorrhagic infarction of testis.jpg
Micrograph of testis showing hemorrhagic infarction. H&E stain.

By localization

File:Histopathology of thalamus infarction at approximately 24 hours, high magnification, annotated.jpg
Histopathology at high magnification of a normal brain neuron, and a brain infarction at approximately 24 hours on H&E stain: The neurons become hypereosinophilic and there is an infiltrate of neutrophils. There is slight edema and loss of normal architecture in the surrounding neuropil.
File:Segmental testicular infarction 112914968.jpg
Ultrasound of segmental testicular infarction. Infarct area shown as hypoechoic and avascular upper segment of R testis.

Associated diseases

Template:Unreferenced section Diseases commonly associated with infarctions include:

First aid

Each type of infarction requires its own care.

Infarction in the heart requires first aid for myocardial infarction (due to acute coronary syndrome).

Infarction in the brain requires first aid for stroke (using a protocol named F.A.S.T.).

References

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