infarction

梗塞

WordNet

1. localized necrosis resulting from obstruction of the blood supply (同)infarction

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/08/28 08:40:09」(JST)

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Not to be confused with Infraction.

Infarction
Micrograph of a pulmonary infarct (right of image) beside relatively normal lung (left of image). H&E stain.
Classification and external resources
Specialty	Pathology

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. The resulting lesion is referred to as an infarct (from the Latin infarctus, "stuffed into").

Myocardial infarction is the partial death of heart tissue commonly known as a heart attack.

Causes

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. 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).

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

Infarction of the lung due to a pulmonary embolism

By histopathology

Infarctions are divided into 2 types according to the amount of blood present:

• 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.
• 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:
  • occlusion of a vein

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

• • loose tissues that allow blood to collect in the infarcted zone
  • tissues with a dual circulatory system (lung, small intestines)
  • tissues previously congested from sluggish venous outflow
  • reperfusion (injury) of previously ischemic tissue that is associated with reperfusion-related diseases, such as myocardial infarction, stroke (cerebral infarction), shock-resuscitation, replantation surgery, frostbite, burns, and organ transplantation.

Micrograph of testis showing hemorrhagic infarction.H&E stain.

By localization

• Heart: Myocardial infarction (MI), commonly known as a heart attack, is an infarction of the heart, causing some heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (fatty acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting ischemia (restriction in blood supply) and oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death of heart muscle tissue (myocardium).
• Brain: Cerebral infarction is the ischemic kind of stroke due to a disturbance in the blood vessels supplying blood to the brain. It can be atherothrombotic or embolic. Stroke caused by cerebral infarction should be distinguished from two other kinds of stroke: cerebral hemorrhage and subarachnoid hemorrhage. Cerebral infarctions vary in their severity with one third of the cases resulting in death.
• Lung: Pulmonary infarction or lung infarction
• Spleen: Splenic infarction occurs when the splenic artery or one of its branches are occluded, for example by a blood clot. Although it can occur asymptomatically, the typical symptom is severe pain in the left upper quadrant of the abdomen, sometimes radiating to the left shoulder. Fever and chills develop in some cases. It has to be differentiated from other causes of acute abdomen.
• Limb: Limb infarction is an infarction of an arm or leg. Causes include arterial embolisms and skeletal muscle infarction as a rare complication of long standing, poorly controlled diabetes mellitus. A major presentation is painful thigh or leg swelling.
• Bone: Infarction of bone results in avascular necrosis. Without blood, the bone tissue dies and the bone collapses. If avascular necrosis involves the bones of a joint, it often leads to destruction of the joint articular surfaces (see osteochondritis dissecans).
• Testicle: an infarction of a testicle may be caused by testicular torsion.

Ultrasound of segmental testicular infarction. Infarct area shown as hypoechoic and avascular upper segment of R testis.

• Eye: an infarction can occur to the central retinal artery which supplies the retina causing sudden visual loss.

Associated diseases

Diseases commonly associated with infarctions include:

• Peripheral artery occlusive disease (the most severe form of which is gangrene)
• Antiphospholipid syndrome
• Sepsis
• Giant-cell arteritis (GCA)
• Hernia
• Volvulus
• Sickle-cell disease

External links

Media related to Infarction at Wikimedia Commons The dictionary definition of infarction at Wiktionary

UpToDate Contents

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• 1. ST上昇型心筋梗塞の急性期マネージメントの概要 overview of the acute management of st elevation myocardial infarction
• 2. 心電図チュートリアル：心筋梗塞 ecg tutorial myocardial infarction
• 3. 急性心筋梗塞の診断基準 criteria for the diagnosis of acute myocardial infarction
• 4. 右室心筋梗塞 right ventricular myocardial infarction
• 5. 心筋梗塞後の上室性不整脈 supraventricular arrhythmias after myocardial infarction

English Journal

• Red yeast rice for dysipidemia.

• Shamim S, Al Badarin FJ, DiNicolantonio JJ, Lavie CJ, O'Keefe JH.SourceMid America Heart Institute, Saint Luke's Hospital, Kansas City, USA.
• Missouri medicine.Mo Med.2014 Jul-Aug;110(4):349-54.
• Red yeast rice is an ancient Chinese food product that contains monacolins, chemical substances that are similar to statins in their mechanisms of action and lipid lowering properties. Several studies have found red yeast rice to be moderately effective at improving the lipid profile, particularly f
• PMID 24003656

• Almost everyone over 50 should be put on a statin to reduce the risk of cardiovascular disease: A contrarian view.

• Mittal M, Fay WP.SourceDepartment of Internal Medicine, University of Missouri School of Medicine, USA.
• Missouri medicine.Mo Med.2014 Jul-Aug;110(4):339-41.
• 3-Hydroxy-3-methyl-glutarylCoA reductase inhibitors, or statins, are a mainstay in the treatment of patients with established coronary artery disease (CAD) because of their proven efficacy in reducing cardiovascular death, myocardial infarction, and coronary revascularization procedures in this pati
• PMID 24003653

• Dual antiplatelet treatment in patients candidates for abdominal surgery.

• Illuminati G, Ceccanei G, Pacilè MA, Pizzardi G, Palumbo P, Vietri F.SourceFrancesco Durante Dept. of Surgery, University of Rome La Sapienza, Rome, Italy. giulio.illuminati@uniroma1.it
• Annali italiani di chirurgia.Ann Ital Chir.2014;83:291-4.
• With the increasing diffusion of percutaneous interventions (PCI), surgeons are often faced with the problem of operating on patients under dual antiplatelet treatment. Replacing dual antiplatelet regiment with low molecular weight heparin may expose to the abrupt thrombosis of coronary stent and ma
• PMID 23103787

Japanese Journal

• 心房細動における脳梗塞のリスク評価とNOAC療法の実際 (第1土曜特集 不整脈を科学する) -- (心房細動を識る・治す)

• 医学のあゆみ 256(6), 742-748, 2016-02-06
• NAID 40020723869

• 冠動脈ステントと血栓イベント : 最近の実態 (特集 循環器領域の血栓症と抗血栓療法)

• 循環器内科 = Cardioangiology 79(1), 18-23, 2016-01
• NAID 40020722865

• アルツハイマー病との鑑別を要した左前部視床梗塞後の軽度認知障害例

• 精神医学 58(1), 81-85, 2016-01
• NAID 40020707188

Related Links

• Infarction - Wikipedia, the free encyclopedia

Micrograph of a pulmonary infarct (right of image) beside relatively normal lung ( left of image). H&E stain. In medicine, infarction refers to tissue death (necrosis) caused by a local lack of oxygen due to obstruction of the tissue's blood supply.

Related Pictures

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★リンクテーブル★

リンク元	「病理学」「梗塞」「infarct」

「病理学」

　　[★]

英

pathology

関

• 画像はまだありません

循環障害

• 浮腫 edema
• 鬱血 congestion
• 出血 hemorrhage
• 止血 hemostasis
• 血栓症 thrombus
• 塞栓症 embolism
• 梗塞 infarction
• ショック shock

代謝障害

• 蛋白質および核酸代謝障害

• アミロイドーシス amyloidosis
• 痛風 gout

• 脂質代謝障害

• 脂肪肝 fatty liver
• 非アルコール性脂肪肝炎 non-alcoholic steatohepatitis
• 粥状硬化症 atherosclerosis
• 脂質症 lipidosis

• 糖代謝障害

• 糖尿病 diabetes mellitus
• 糖原病 glycogen storage disease

• 無機質代謝障害

• カルシウム代謝障害

• 病的石灰化 pathologic calcification

• 結石 calculi

• 胆石症 cholelithiasis
• 尿路結石症 urolithiasis

• 色素代謝障害

• メラニン melanin
• リポフスチン lipofuscin
• ヘモジデリン hemosiderine

• ヘモクロマトーシス hemochromatosis

• ビリルビン bilirubin

• 黄疸

参考

• 東大病理学教室　病理標本が多い
• http://pathol.umin.ac.jp/gakubu.shtml

「梗塞」

　　[★]

英

infarct, infarction

ラ

infarctus

同

虚血性壊死

関

心筋梗塞 myocardial infarction

「infarct」

　　[★]

• n.

• 梗塞、梗塞巣

関

infarct area、infarction