PATHOLOGY OF INTACT MYOCARDIUM AND CORONARY-ARTERIES IN ACUTE MYOCARDIAL-INFARCTION COMPLICATED BY CARDIOGENIC-SHOCK

Myocardial pathology in myocardial infarction with cardiogenic shock has some specific features characterized by development of diffuse contractural lesions of cardiomyocytes present both in border zone of the necrosis and in intact myocardium; These lesions and high frequency of scars (prevalence of repetitive infarctions in patients with shock is twice as high as in patients without shock) determine the fact that total mass of injured myocardiam in patients with cardiogenic shock is significantly higher than in patients without shock. Disturbances of microcirculation - venous stasis, spasms of minor arteries and arterioles, ''empty'' capillaries - observed in intact myocardium are evidences of sequential involvement of the heart as a target organ during development of shock.