Segmental Arterial Mediolysis: A Multiguised Vasospastic Arteriopathy with Collateral Mesangial Cell Hyperplasia and Cardiac Toxicity Generated by Norepinephrine and Hyperdense Adrenoceptors Alone or by Crosstalk with Other Pressor Agents

Figure 36

Myocardium in segmental arterial mediolysis. The cytoplasm of most myocytes shows alcian blue-negative vacuoles (hydropic mitochondria). Disruption of the vacuolar membranes has caused the coalescence of their contents filling the cells with minute lakes of water similar to smooth muscle in SAM (Figure 3). Edematous fluid derived from disrupted myocytes containing alcian blue matrix material stemming from the early reparative granulation tissue is evident in the interstitial tissue separating the degenerating myocytes. Movat stain ×200 (adapted from EC Cardiology 5.7 2018, online publication).