[Morphology of acute myocardial infarction at prenecrotic stage].

We studied morphological changes of myocardium and content of glucose, potassium, calcium, sodium in pericardial fluid in persons who died suddenly of myocardial infarction at its prenecrotic stage at prehospital phase. It was established that acute myocardial infarction at prenecrotic stage can run in 2 morphological forms - either with transmural or with subendo- or epicardial localization of ischemic process in left ventricular wall. Transmural injury is characterized by large volume of ischemic damage of the left ventricle, generalized spasm of arterial system of the heart, changes of cardiomyocytes with derangement of their energy metabolism and contractile capacity. In subendo- or epicardial localization foci of ischemic injury alternated with areas of normal blood supply. Similar character of disturbances of rheological properties of blood with thrombosis of microcirculatory bed and of number of markers of ventricular fibrillation between these two forms create preconditions for increase of the zone of necrosis in myocardium and cause high risk of development of rhythm disorders.