Anemic infarct

Anemic infarct refers to a type of tissue necrosis (death of tissue) that occurs due to the sudden loss of blood supply to a specific area, leading to ischemia and subsequent infarction without the presence of blood or hemorrhage in the affected tissue. This condition is most commonly associated with organs that have a single or end-arterial blood supply, such as the heart, kidneys, and spleen. Anemic infarcts are also known as pale infarcts or white infarcts, contrasting with hemorrhagic infarcts that involve bleeding into the tissue.

Causes

Anemic infarcts are primarily caused by arterial occlusion due to various factors, including thrombosis, embolism, or external compression of blood vessels. In the heart, coronary artery occlusion, often due to atherosclerosis, can lead to myocardial infarction. In the kidneys, conditions such as renal artery stenosis can precipitate an infarct. The spleen may suffer anemic infarction from emboli originating from the heart or from conditions that lead to splenic artery occlusion.

Pathophysiology

The pathophysiology of anemic infarct involves the interruption of blood supply to an organ or tissue, leading to a deprivation of oxygen (hypoxia) and nutrients. This results in ischemia and, if the blood supply is not restored, leads to cell death and tissue necrosis. The affected area typically appears pale and firm, in contrast to the surrounding viable tissue, due to the lack of blood. Over time, the dead tissue may be cleared by the action of white blood cells and replaced with scar tissue, leading to potential loss of function depending on the organ involved.

Clinical Features

The symptoms of an anemic infarct vary depending on the organ affected but generally include sudden onset of pain, loss of function, and sometimes fever. For example, a myocardial infarction may present with chest pain, shortness of breath, and sweating. A renal infarct might cause flank pain and hematuria, while a splenic infarct could lead to left upper quadrant abdominal pain and tenderness.

Diagnosis

Diagnosis of anemic infarct involves a combination of clinical assessment, laboratory tests, and imaging studies. Electrocardiogram (ECG) and cardiac markers are used for diagnosing myocardial infarction. Imaging techniques such as computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasound can help identify infarcts in the kidneys, spleen, and other organs by showing areas of tissue necrosis and lack of blood flow.

Treatment

Treatment of anemic infarct focuses on restoring blood flow to the affected area, if possible, and managing symptoms. This may involve the use of medications such as anticoagulants and thrombolytics, or surgical interventions like angioplasty for coronary artery disease. Pain management and supportive care are also important aspects of treatment.

Prevention

Preventing anemic infarcts involves managing risk factors for arterial occlusion, such as controlling hypertension, diabetes, and hyperlipidemia, and adopting a healthy lifestyle with regular exercise and a balanced diet.