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Myocardial Infarct - Determining Age of an Infarct by Histopathologic Exam

Time After Event Histopathologic Findings
4-6 Hours Margination of polymorphonuclear leukocytes
8-12Hours Diapedesis of polymorphonuclear leukocytes into the myocardial interstitial space
1 day Hypereosinophilic fibers, nuclear pyknosis, coagulation necrosis, colliquative myocytolysis, edema, interstitial hemorrhage, contraction band necrosis, increase in neutrophilic infiltration
2-3 days Marked polymorphonuclear infiltrate with extensive karyorrhexis, loss of myocyte nuclei
4 days to 1 Week Macrophage infiltration, early granulation tissue with fibroblast response and capillary proliferation at the edges
7 to 14 days Granulation tissue with hemosiderin-laden macrophages; variable amount of lymphocytes, rare plasma cells and eosinophils; polymorphonuclear leukocytes have disappeared
2-8 weeks Granulation tissue matures with increased collagen deposition, which becomes prominent and more dense
2 months Healed scar

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