This is why Cao Dong said his first impression of this pathological section was that it was a myocardial necrosis section. Indeed, one of the characteristics of myocardial fibrosis is the death of myocardial cells.
Dr. Cao Dong’s main job is as a clinical doctor, and he speaks in a simple and straightforward manner.
If researchers want to conduct in-depth academic discussions, they cannot simply say myocardial fibrosis or myocardial necrosis. The accurate description should be pathological description, and if they want to diagnose the patient on this slice, they cannot simply say it is a myocardial necrosis slice.
The first point that needs to be made clear is that myocardial fibrosis is a pathological diagnosis term, not a disease name. It is actually divided into two types. One is reactive fibrosis, which occurs around blood vessels and is a lesion in which the myocardium responds 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, etc.
Recalling the cases we have mentioned before, we can roughly infer that patients with valvular cardiomyopathy are expected to have this lesion. The reason why it was not emphasized before is that pathological anatomy cannot be performed in vivo for this examination, and only a myocardial biopsy can be performed. Myocardial biopsy around blood vessels is not easy to perform and the potential risks of the examination to the patient must be considered.
We are now talking about the significance of scientific research. Doing pathological analysis after death seems like hindsight, but a thorough study of the pathogenesis can bring good news to other patients. It can be said that every patient is sacrificing himself to benefit future patients. Human medicine is the most representative of the great justice of mankind and the true meaning of a community with a shared future.
Another type of myocardial fibrosis is the response to myocardial cell death mentioned above. After myocardial fibrosis, repair scar formation is called reparative fibrosis. It often occurs not around blood vessels, but in the myocardial interstitium, and the corresponding common patient type is myocardial infarction and myocarditis patients.
In specific clinical cases, the two types of remodeling often occur together in cases of ventricular remodeling. For example, in patients with myocardial infarction, the periphery of the repair scar is composed of reactive fibrosis and hypertrophic myocardial cells surrounding the scar area.
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As for the great harm of myocardial fibrosis, you can directly refer to Xiao Shugang for example.
Let's talk about this pathological section again. There are large areas of myocardial fibrosis and almost nothing else. It is really rare. The pathology of patients with myocardial infarction will still have a little granulation tissue on the edge many days later.
"It's possible that the location was not right." said teacher Yuan Fang.
When doing pathological sections, you need to select the appropriate lesion. If the location is not accurate, it may not represent the pathological characteristics of the entire human organ. What Professor Yuan Fang said makes sense.
What Cao Yudong needs to correct is: "What you said is possible. But if not, we should probably consider other causes and diagnoses."
All aspects should be taken into consideration during the discussion.
In fact, most heart diseases have the pathological characteristics of myocardial fibrosis. Looking back at the examples of patients with myocardial fibrosis, they almost cover all types of heart disease patients.
Here’s some cool news: patients with conditions including drowning may develop myocardial fibrosis.
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