Primary PCI and its silent encounter with “ myocardial neutrophilia ”

Myocardial infarction,  a gross pathological entity renamed now as STEMI for clinical purposes, is the most famous medical emergency that triggers a series of calls. Right from 911/First medical contact, the ER, that ends up in CCU or a 24/7 cath lab. The heart, can’t wait for all these external responses when it is challenged with a vascular accident. The moment ATO occurs, two things happen. The endogenous fibrinolytic led by native tissue PA (Tpa) tries to get rid of the thrombotic plug by all its means. It succeeds in 15%. We call it spontaneous lysis or aborted MI. Many lives are lost in the remaining before they reach the hospital. Meanwhile, the immune high-command deputes scores of neutrophils to the accident site(Fig 1) to supervise what is happening and try to heal the injury. It is worth, understanding that activated WBCs convert acute myocardial infarction from a vascular event to inflammatory pathology as the hour progress.   Fig 1  Infarcted myocardium Invaded by neutrophils       What do these neutrophils do?   It will be our ignorance, if we think, they simply crowd around the myocytes helplessly, that is hit by ischemia. They are sent with a specific purpose to protect and heal the myocardium. Very often it fails in its mission is a different story. These fighting neutrophils send a subtle signal  of their presence with a mild increase in temperature during ACS  ( Patel  Prognostic usefulness of white blo...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized myocardial neutrophilia Source Type: blogs