於t油 ocardial infarction was documented at autopsy The gross and with the degree of coronary atherosclerosi and its complicatio ,clinical symptoms,an therapies given before deat morrhage and contraction bands in necrotic myocardial fibers are MOST LIKELY to be seen in which of the following types of infarcts? A.Healing transmural myocardial infarct B.Subendocardial infarct resulting from diffuse narrowing or coronary arteries C.Transmural infarct caused by complete thrombotic occlusion of a coronary artery D.Transmural infarct complicated by mural thrombosis E.Transmural infarct reperfused by thrombolytic therapy AnsF Reperfusion of an ischemic mvocardium by spontaneous or therapeutic thrombolysis changes the morphologic features of the affected a period of ischemia leads to of blood into the rhage).Co ction bands f closely acked ted are m likely pro sly injured are exposed to a high the aThe membran be a prominent feature of the other options 6.Which procedure yields the HIGHEST incidence of vessel patency after 10 years? A.Aspirin plus Plavix,p.o. B.Balloon angioplasty,left anterior descending coronary artery C.Bare endoluminal stent in left anterior descending coronary artery D.Left internal thoracic(mammary)artery to left anterior descending coronary artery E.Reverse saphenous vein to left anterior descending coronary artery Ans:D Clinical trials have demonstrated that arterial grafting to circumvent a region of stenosis maintains the highest incidence of vessel patency over the long term.As pirin and Plavix minimize the risk of thrombotic occlusion of an artery narrowed by atherosclerotic plac ue.Ballo gioplasty is an effective immediate therapy,but dueto eated vessel y bec over the longtermA bare sten may be thro5. A study of ischemic heart disease analyzes cases in which myocardial infarction was documented at autopsy. The gross and microscopic appearances of the hearts are correlated with the degree of coronary atherosclerosis and its complications, clinical symptoms, and therapies given before death. Hemorrhage and contraction bands in necrotic myocardial fibers are MOST LIKELY to be seen in which of the following types of infarcts? A. Healing transmural myocardial infarct B. Subendocardial infarct resulting from diffuse narrowing or coronary arteries C. Transmural infarct caused by complete thrombotic occlusion of a coronary artery D. Transmural infarct complicated by mural thrombosis E. Transmural infarct reperfused by thrombolytic therapy Ans: E Reperfusion of an ischemic myocardium by spontaneous or therapeutic thrombolysis changes the morphologic features of the affected area. Reflow of blood into the vasculature injured during a period of ischemia leads to leakage of blood into the tissues (hemorrhage). Contraction bands are composed of closely packed hypercontracted sarcomeres. They are most likely produced by exaggerated contraction of previously injured myofibrils that are exposed to a high concentration of calcium ions from the plasma. The damaged cell membrane of the injured myocardial cells allows calcium to penetrate the cells rapidly. Hemorrhage would not be a prominent feature of the other options. 6. Which procedure yields the HIGHEST incidence of vessel patency after 10 years? A. Aspirin plus Plavix, p.o. B. Balloon angioplasty, left anterior descending coronary artery C. Bare endoluminal stent in left anterior descending coronary artery D. Left internal thoracic (mammary) artery to left anterior descending coronary artery E. Reverse saphenous vein to left anterior descending coronary artery Ans: D Clinical trials have demonstrated that arterial grafting to circumvent a region of stenosis maintains the highest incidence of vessel patency over the long term. Aspirin and Plavix minimize the risk of thrombotic occlusion of an artery narrowed by atherosclerotic plaque. Balloon angioplasty is an effective immediate therapy, but due to intimal injury incurred during therapy the treated vessel may become occluded over the long term. A bare stent may be thrombogenic. While useful, a venous graft is less likely to remain patent than an arterial graft