Chapter 3402 【3402】Cold Knowledge

This is why Cao Dong's first impression when he observed this pathological section was a section of myocardial necrosis. It is true that one of the characteristics of myocardial fibrosis is the death of myocardial cells.

Dr. Cao Dong's main job is as a clinician, and his speech is relatively simple and straightforward.

If you want to conduct in-depth academic research, you can't just say myocardial fibrosis in a general way, and you can't say that the impression is myocardial necrosis slices. The accurate statement should be the pathological description, and if we want to diagnose the patient on this slice, it cannot simply be said to be a slice of myocardial necrosis.

The first point that needs to be clear is that myocardial fibrosis is a pathological diagnosis term rather than a disease name. It is actually divided into two types. One is reactive fibrosis, which occurs around blood vessels and is a lesion of the heart muscle in response to myocardial load and inflammation.

Through this definition, we can know that this pathological lesion usually occurs in patients with myocardial load or inflammation, such as hypertrophic cardiomyopathy, left ventricular hypertrophy, aortic stenosis, myocarditis and other patients.

Recalling the cases we have mentioned before, it can be roughly speculated that patients with cardiomyopathy with valvular disease are expected to have this lesion. The reason why I didn’t focus on it before is because pathological anatomy cannot be done in the living body for this test, only a myocardial biopsy can be done. Perivascular myocardium biopsies are not easily performed and the potential risks to the patient must be considered.

Let's talk about the significance of scientific research now. Pathological analysis after death is like an afterthought, but a thorough study of the pathogenesis can bring good news to other patients. It can be said that each patient is benefiting the future patients at the expense of himself, and human medicine is the most prominent manifestation of the righteousness of mankind and the true meaning of a community with a shared future.

Another type of myocardial fibrosis is the above-mentioned response to myocardial cell death, and repair scar formation after myocardial fibrosis is called repair fibrosis. It often occurs not around blood vessels, but in the myocardial interstitium. The corresponding common patient type is myocardial infarction and myocarditis patients.

When it comes to specific clinical cases, in cases of ventricular remodeling, the two types often occur together. For example, in patients with myocardial infarction, the periphery of the repair scar is composed of reactive fibrosis and hypertrophic cardiomyocytes surrounding the scar area.

Regarding the great harm of myocardial fibrosis, you can directly refer to Xiao Shugang as an example.

Looking back, this pathological section has a large area of ​​myocardial fibrosis, and almost nothing else is seen, which is really rare. The pathology of patients with myocardial infarction after many days will still have a little granulation tissue at the edge.

"It's possible that it's not in the right place," Yuan Fang said.

For pathological sectioning, appropriate lesions should be selected. If the location is not accurate, it may not represent the pathological characteristics of the entire human organ. What Teacher Yuan Fang said has some truth.

What Cao Yudong needs to correct is: "There is a possibility of what you said. But if it is not, we may have to consider other etiologies and diagnoses."

Take everything into consideration when discussing.

In fact, most heart diseases are characterized by myocardial fibrosis. Looking back at the examples of patients with myocardial fibrosis, almost all types of heart disease patients are covered.

Cold knowledge has arrived, including patients such as drowning, which may cause myocardial fibrosis.