Page 231 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

D. Acute Ischemia in Coronary Atherosclerosis
Atheroma
Normal Coronary atheroma
(concentric)
Atheroma
Spasm (10.6 mm )
2
Thrombus
(local,
embolic)
Dilated Constricted Dilated Constricted
Circumference of muscle ring 100% 95% 100% 95% Myocardial Infarction II
Internal radius (mm) 2 1.9 0.78 0.47
2
Lumen area (mm ) 12.5 11.3 1.9 0.7
Lumen area reduced by 0% 10% 85% 94%
Resistance (∼ 1/r ) 4 (1) x 1.2 x 43 x 328
(muscle wall thickness ignored)
E. Excitation of Myocardial Cell in Ischemia Plate 7.24
Ischemia after 180 min
Normal after 30 min after 60 min
(after Boineau and Cox)

13 mV 7 mV 5 mV 2 mV
50 ms
Bipolar intramural electrogram
F. ECG in Coronary Infarction
R ECG
ECG pattern 4
reverse of that P
on the
opposite side Q T 2
R
P 1
T Stage 2
Q (days to weeks)
R
R 5
P T P 3
Infarction Q S T
Stage 1
(hours to days)
Stage 3
(months to years) 221
(after Netter)
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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