Which type of necrosis primarily follows a myocardial infarction?

Coagulative necrosis is the type of necrosis that typically follows a myocardial infarction. This form of necrosis occurs due to an interruption of blood flow, which leads to ischemia and subsequently cell death. In the case of myocardial infarction, which is caused by the blockage of coronary arteries, the affected heart muscle cells (myocytes) undergo coagulative necrosis.

This process is characterized by the preservation of the basic tissue architecture while the affected cells lose their normal structure and function. The cellular outlines remain visible, but there is a loss of cellular detail and function due to denaturation of proteins, particularly enzymes, which is intensified by the lack of oxygen. In the aftermath, inflammation and repair mechanisms come into play, and eventually, scar tissue forms in the area of necrosis.

In contrast, other forms of necrosis are associated with different pathological conditions. For example, caseous necrosis is often seen in tuberculosis infections, liquefactive necrosis typically occurs in bacterial infections leading to pus formation, and fat necrosis is associated with pancreatic injury or trauma to fatty tissue. Understanding these distinctions clarifies why coagulative necrosis is the appropriate answer in the context of myocardial infarction.