A 60-year-old obese woman (BMI = 35 kg/m^2) suddenly develops crushing substerna

Question

A 60-year-old obese woman (BMI = 35 kg/m^2) suddenly develops crushing substernal chest pain. An electrocardiogram is consistent with myocardial infarction. A cardiac catheterization shows a thrombus in the left coronary artery. Tissue plasminogen activator is infused, and there is lysis of the clot. Reperfusion injury that occurs in the ischemic heart muscle of this patient is most likely caused by the release of activated oxygen species from which of the following cells?

Neutrophils Mast cells Macrophages Eosinphils Lymphocytes

Explanation / Answer

Reperfusion injury causes more damage than the initial ischemia. Reintroduction of blood flow brings oxygen back to the tissues. The vascular endothelial cells produce more reactive oxygen species and less itric oxide, following perfusion. The imbalance results in inflammatory response. The inflamatory factors released by endothelial cells attract macrophages and neutrophil, which release cytokines and further lead to tissue damage.

Neutrophiles have a limited role, whereas Macrophages play a major role in reperfusion damage. However, both the cells, neutrophils and macrophages, contribute to the damage.

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