What is an infarction
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Understanding Infarction: Cerebral and Myocardial Infarction
Definition of Infarction
Infarction refers to the death of tissue due to a lack of blood supply, which results in prolonged ischemia. This condition can affect various organs, including the brain and heart, leading to significant health issues and even death.
Cerebral Infarction: Causes and Definition
Causes of Cerebral Infarction
Cerebral infarction, commonly known as a stroke, occurs when blood flow to a part of the brain is obstructed, leading to the death of brain cells. This can be due to various reasons, including thromboembolism, systemic hypotension, or microembolism. Watershed infarcts, a specific type of cerebral infarction, occur in the border zones between major cerebral arteries and are often caused by systemic hypotension or microembolism.
Universal Definition of Cerebral Infarction
Recent advancements in diagnostic techniques have led to a proposed universal definition of cerebral infarction. It is defined as brain or retinal cell death due to prolonged ischemia. This definition includes both complete and incomplete infarcts, making it highly relevant for clinical practice and patient care. The use of imaging biomarkers like diffusion MRI and cerebral blood volume CT has been instrumental in identifying neuronal injury, thus refining the criteria for cerebral infarction.
Myocardial Infarction: Causes and Definition
Causes of Myocardial Infarction
Myocardial infarction, commonly known as a heart attack, is primarily caused by the thrombotic occlusion of a coronary vessel due to the rupture of a vulnerable plaque. This leads to ischemic death of myocardial tissue, which is characterized by profound metabolic and ionic disturbances in the affected myocardium. The heart's limited regenerative capacity means that the infarcted myocardium heals through scar formation, involving an inflammatory cascade and subsequent tissue remodeling.
Universal Definition of Myocardial Infarction
The universal definition of myocardial infarction involves the detection of myocardial injury through abnormal cardiac biomarkers, particularly cardiac troponins, in the context of acute clinical myocardial ischemia. This is confirmed by a rise and/or fall of cardiac biomarkers with at least one value above the 99th percentile of the upper reference limit, along with evidence of acute clinical myocardial ischemia such as ischemic symptoms, ECG changes, imaging evidence, or identification of an intracoronary thrombus. This definition helps in distinguishing myocardial infarction from other forms of coronary artery disease and is crucial for clinical practice, epidemiology, and clinical trials .
Conclusion
Infarction, whether cerebral or myocardial, is a critical medical condition resulting from prolonged ischemia leading to tissue death. The universal definitions for cerebral and myocardial infarctions provide a standardized framework for diagnosis and treatment, enhancing patient care and facilitating research. Understanding the causes and diagnostic criteria of these conditions is essential for effective management and improving patient outcomes.
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