Как пример - перенесенный ИМ у бодибилдера на ногах через 2 недели закончился смертью - на вскрытии с сердцем и коронарами все ОК, лишь в миокарде - очаг некроза, занимающий 20% левого желудочка:
A 32-year-old bodybuilder suddenly lost consciousness during
a weight lifting workout at the gymnasium. After an unsuccessful
resuscitation attempt, he was pronounced dead because of an
instantaneous cardiac arrest. Two weeks earlier, he had experienced
an episode of chest pain that lasted a few minutes, with
pain radiating to his left arm. According to relatives and friends,
the patient did not consult a doctor and continued his training,
believing that the pain was caused by his physical activity. For
several months he was taking testosterone propionate (700 mg/
wk) and nandrolone (200 mg/wk) parenterally, and he was taking
stanozolol per os (70 mg/wk). His medical history was unremarkable.
The pericardium, cardiac valves, endocardium, and coronary arteries were normal.
In particular, the latter and their major branches were cross-sectioned
at 3-mm intervals, with no gross evidence of lesion or lumen reduction.
The myocardium was usual in appearance except for one grayish
zone in the internal half of the anterior-lateral wall of the left
ventricle. It corresponded to 20% of the whole left ventricular
myocardial mass, including the interventricular septum. No
thrombi were noted in the cardiac cavities...
Histologically, the grayish area corresponded to typical infarct
necrosis with a histologic age of approximately 15 days.
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