Physio-1

1.Transmural:  more common / involve the entire thickness of myocardium

2. Subendocardial:  less common / only involve inner portions of myocardium

• 1.Altered ion gradients
• 2. Drop in intracellular pH

• 1.­ vascular permeability
• 2.Tissue edema (wavy fibers)
• 3.Neutrophil infiltration
• 4.Coagulation necrosis

• 1.Resorption of dead tissue
• 2.Fibroblasts deposit new collagen matrix (fibrosis) 

• 1.Myocytes revert to glycolysis
• 2.LessATP is being produced
• 3.Morelactic acid being produced
• 4.Decrease in systolic contraction and diastolic relaxation
• 5.Accumulationof waste products stimulates pain receptors

• 1.Pain triggers discharge of both sympathetic and parasympathetic systems
• 2.Increased sympathetics trigger increased heart and respiratory rates
• 3.Increased parasympathetics trigger nausea
• 4. Decreased systolic contraction and diastolic relaxation lead to pulmonary congestion