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Question 58#

After serious ischaemia of tissues in the microcirculation the ‘no-reflow’ phenomenon can appear, that consists of several events and factors except for:

a. Microvascular spasm
b. Interstitial oedema
c. Microthrombi
d. Myoglobinuria
e. Swollen myocytes compressing vessel

Correct Answer is D

Comment:

Tissue/organ ischaemia causes complex pathophysiological processes depending on the duration and extent of the ischaemia. During reperfusion in the microcirculatory bed a ‘no-reflow’ phenomenon can be caused by microvascular spasm, swelling of endothelial cells, endothelial ‘blebs’, increased capillary permeability, interstitial oedema, microthrombi, plugged red blood cell aggregates, adhesion and plugging of neutrophil leukocytes, local acidosis and swollen myocytes around compressing vessels. 

References:
1. Reffelmann T, Kloner RA. The ‘no-reflow’ phenomenon: basic science and clinical correlates. Heart 2002; 87: 162-8.