ST elevation myocardial infarction gross pathology

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Pathophysiology of Vessel Occlusion
Pathophysiology of Reperfusion
Gross Pathology


Differentiating ST elevation myocardial infarction from other Diseases

Epidemiology and Demographics

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Natural History and Complications

Risk Stratification and Prognosis



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STEMI and Out-of-Hospital Cardiac Arrest
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Reperfusion at a Non–PCI-Capable Hospital:Recommendations
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The importance of reducing Door-to-Balloon times
Primary PCI
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Factor Xa Inhibition
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Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

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Long-Term Medical Therapy and Secondary Prevention

Inhibition of the Renin-Angiotensin-Aldosterone System
Cardiac Rehabilitation
Pacemaker Implantation
Long Term Anticoagulation
Implantable Cardioverter Defibrillator
ICD implantation within 40 days of myocardial infarction
ICD within 90 days of revascularization

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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

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:


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.


  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)