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Case Reports
. 2018 Jul 30;8(3):e2018032.
doi: 10.4322/acr.2018.032. eCollection 2018 Jul-Sep.

Perioperative myocardial infarction: diagnostic clues and prevention

Larry Nichols  1
Affiliations
Case Reports

Perioperative myocardial infarction: diagnostic clues and prevention

Larry Nichols. Autops Case Rep. .

Abstract

The diagnosis of perioperative myocardial infarction can be missed if the pain is masked by postoperative analgesia and the possibility is not considered. This report is the case of a patient with a missed diagnosis of perioperative myocardial infarction. Myocardial injury and infarction from noncardiac surgery is currently the subject of intense interest and research. This report illustrates the importance of the diagnosis and suggests clues that can be used to make the diagnosis.

Keywords: Autopsy; Cognitive dysfunction; Diagnostic errors; General surgery; Myocardial infarction.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. The dead cardiac myocytes (all but lower right corner) show hypereosinophilia and loss of nuclei, associated with an infiltrate of degenerating neutrophils, many of which have lysed, releasing basophilic debris (nuclear dust).
Figure 2
Figure 2. The apparent gaps in this luminal thrombosis are due to artefactual tissue folding, particularly around two calcifications, one of which has been pushed out of the tissue section by the microtome blade.
See this image and copyright information in PMC

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References

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