Ruptured intercalated discs: Difference between revisions
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|author1=[[User:Mikael Häggström|Mikael Häggström]] | |author1=[[User:Mikael Häggström|Mikael Häggström]] | ||
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[[File:Histopathology of ruptured intercalated discs.jpg|thumb|Ruptured intercalated discs, in this case regarded as a visual artifact, and was not reported.]] | [[File:Histopathology of ruptured intercalated discs.jpg|thumb|Ruptured intercalated discs, in this case regarded as a visual artifact, and was not reported.]] | ||
Ruptured intercalated discs of myocytes of the '''[[heart]]''' have two main causes: | Ruptured intercalated discs of myocytes of the '''[[heart]]''' have two main causes: | ||
*'''Microtome processing''', thereby being a visual artifact,<ref>[https://books.google.se/books?id=7SxiDwAAQBAJ&pg=PA38 Page 38] in: {{cite book|title=The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition|author=Giorgio Baroldi|publisher=CRC Press|year=2004|isbn=9781498712811}}</ref> not needing reporting. | *'''Microtome processing''', thereby being a visual artifact,<ref>[https://books.google.se/books?id=7SxiDwAAQBAJ&pg=PA38 Page 38] in: {{cite book|title=The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition|author=Giorgio Baroldi|publisher=CRC Press|year=2004|isbn=9781498712811}}</ref> not needing reporting. | ||
*'''Forceful myocardial contraction''', at least in case of [[heart autopsy]]. This is mainly caused by ventricular fibrillation<ref name=Fineschi2016>[https://books.google.se/books?id=PcsqBgAAQBAJ&pg=PA55 Page 55] in: {{cite book|title=Pathology of the Heart and Sudden Death in Forensic Medicine|author=Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver|publisher=CRC Press|year=2016|isbn=9781420006438}}</ref> or electric shock,<ref name="FineschiKarch2005">{{cite journal|last1=Fineschi|first1=Vittorio|last2=Karch|first2=Steven B.|last3=D'Errico|first3=Stefano|last4=Pomara|first4=Cristoforo|last5=Riezzo|first5=Irene|last6=Turillazzi|first6=Emanuela|title=Cardiac pathology in death from electrocution|journal=International Journal of Legal Medicine|volume=120|issue=2|year=2005|pages=79–82|issn=0937-9827|doi=10.1007/s00414-005-0011-8}}</ref> | *'''Forceful myocardial contraction''', at least in case of [[heart autopsy]]. This is mainly caused by ventricular fibrillation<ref name=Fineschi2016>[https://books.google.se/books?id=PcsqBgAAQBAJ&pg=PA55 Page 55] in: {{cite book|title=Pathology of the Heart and Sudden Death in Forensic Medicine|author=Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver|publisher=CRC Press|year=2016|isbn=9781420006438}}</ref> or electric shock,<ref name="FineschiKarch2005">{{cite journal|last1=Fineschi|first1=Vittorio|last2=Karch|first2=Steven B.|last3=D'Errico|first3=Stefano|last4=Pomara|first4=Cristoforo|last5=Riezzo|first5=Irene|last6=Turillazzi|first6=Emanuela|title=Cardiac pathology in death from electrocution|journal=International Journal of Legal Medicine|volume=120|issue=2|year=2005|pages=79–82|issn=0937-9827|doi=10.1007/s00414-005-0011-8}}</ref> | ||
If a lab often cause it as a visual artifact, it may be ignored in the report.<ref group="notes">Repeated artifacts from a lab motivates measures to improve techniques.</ref> If not, look for signs indicating forceful myocardial contraction, and thereby the mentioning of the findings in the report. Such signs are:<ref name=Fineschi2016/><ref name="FineschiKarch2005"/> | |||
*Alternating bundles of hypercontracted myocytes with hyperdistended ones. | *Alternating bundles of hypercontracted myocytes with hyperdistended ones. | ||
*Square-shaped myocardiocyte nuclei. | *Square-shaped myocardiocyte nuclei. | ||
*Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes. | *Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes. | ||
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File:Free nuclei from myocardiocytes.jpg|Cases with ruptured intercalated discs often also display free myocardial nuclei or nuclear fragments, which should not be confused with a lymphocytic infiltrate. | |||
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