This infographic breaks down the different responses of the heart muscle to myocardial ischemia, from early reversible states to irreversible damage. The spectrum begins with acute ischemia, which, if prolonged and severe, can lead to myocardial necrosis (non-viable tissue, forming a scar). Necrosis is marked by calcium overload and oxygen free radical production, causing permanent dysfunction in the cardiac myocytes.
In less severe cases, revascularization efforts can restore function. The heart may exhibit:
- Myocardial hibernation: A state where the myocardium shows reduced function but remains viable. With restoration of blood flow, these cells can gradually recover over days to weeks.
- Myocardial stunning: A condition where the heart remains temporarily dysfunctional even after blood flow is restored, often following repetitive ischemic episodes.
These states result in different levels of left ventricular ejection fraction (LVEF) recovery. While both hibernation and stunning involve hypokinesis or akinesis, they differ in the timeline and mechanism of recovery. This visual guide helps clinicians understand the nuanced cardiac responses, facilitating appropriate diagnosis and treatment strategies.
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