A patient undergoes successful primary angioplasty for an acute STEMI. Histological examination of myocardium taken at autopsy later shows bands of hypercontracted, clumped sarcomeres with dense eosinophilic transverse lines across myocytes. This finding is characteristic of:

• A Chronic ischemic cardiomyopathy
• B Coagulation necrosis of evolving infarction
• C Myofiber disarray of hypertrophic cardiomyopathy
• D Reperfusion injury ✓

Explanation

Contraction band necrosis results from restored blood flow delivering calcium to reversibly injured myocytes with damaged sarcolemmal membranes, causing hypercontraction of sarcomeres. It is the morphological hallmark of reperfusion injury following thrombolysis or angioplasty. Coagulation necrosis of ordinary infarction shows wavy fibers, hypereosinophilia and loss of nuclei, but no dense contraction bands, which excludes option B.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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