Myocardial infarction can be occurred due to interruption in the blood supply to any part of the heart which can lead to death of the cardiac tissue (myocardial necrosis
) (Zaki et al., 2014).
In a small proportion of patients presenting with acute coronary syndrome (ACS), as suggested by chest pain and elevated biomarkers for myocardial necrosis
such as high-sensitivity troponin T, coronary angiography reveals unobstructed coronary arteries.
In summary, use of the "generation 5", or high-sensitivity Troponin T presents a new, more efficient way to rule in or out the presence of myocardial necrosis
in patients presenting with chest pain.
The myocardium of SHAM rats had a normal architecture and clear myocyte boundaries, whereas CLP rats after 18 h of sepsis showed marked myocardial injury with myocardial necrosis
and interstitial edema adjacent to localized extravasation of red blood cells.
MI results in myocardial necrosis
, injury and ischaemia, each of which is reflected by different and distinctive electrocardiographic manifestations.
cTnI is a low molecular weight and contractile protein that is normally not found in serum but is released when myocardial necrosis
It is caused by the metabolic imbalance involving elevated energy requirements and deficient oxygen supply to the cardiac myocytes, ultimately leading to myocardial necrosis
Acute myocardial infarction (AMI) is a clinical manifestation of coronary disease resulting from coronary artery occlusion that leads to irreversible myocardial ischemia and progresses to myocardial necrosis
. In contrast to stable and unstable angina pectoris, where ischemia is transient and myocardial changes are reversible, AMI is characterized by a permanent damage, loss of cardiac tissue, and impairment of left ventricular function .
Cardiac troponin (cTn)*  is considered the biomarker most specific for ischemia-related myocardial necrosis
. With implementation of high-sensitivity (hs)-cTn assays, which detect cTn in [greater than or equal to]50% of a healthy population and exhibit [less than or equal to]10% imprecision at the diagnostic cutoff, sex-specific differences have been reported (1).
The biochemical diagnosis of myocardial necrosis
at the hospital admission of the patient and in the following days allows to assess the progress of ischemia.
There is strong evidence in the literature that contrast CMR with late gadolinium images, is a good diagnostic modality to detect myocardial necrosis
and fibrosis both in ischaemic heart disease and in other types of non-ischaemic lesions.7 In myocarditis, the late gadolinium enhancement (LGE) is patchy or multifocal in a sub-epicardial or intra-myocardial distribution, usually involving the lateral wall.
The presence of ST segment depression (reciprocal changes) in precordial leads during acute inferior wall myocardial infarction is associated with greater myocardial necrosis
hence left ventricular dysfunction and more frequent left coronary artery disease.