[The effect of autolysis on the interpretation of results of immunohistochemical detection of myoglobin and fibrinogen in the myocardium].

Immunohistochemical detection of myoglobin and fibrinogen in the myocardium makes it possible to diagnose very early stages of ischaemic/hypoxic changes of the heart muscle. The authors demonstrate on the myocardium of a 58-years-old female patients who died suddenly with the finding of acute infarction of the anterior wall of the left ventricle with transmural rupture and cardiac tamponade the effect of autolysis on this examination. Tissue excision taken from the close vicinity of the rupture were subjected to autolysis at room temperature and immersed in formol for fixation within an interval of 24 hours. The control series of examinations was made in a similar way on the heart muscle of a 20-years-old woman who died from violent death, and ischaemic changes of the heart muscle were not anticipated. While in the early stages of autolysis it was possible to use combined immunohistochemical detection of myoglobin and fibrinogen, after a longer postmortal interval extensive artificial losses of myoglobin were observed, and the method of detection of fibrinogen deposits in damaged cardiomyocytes seemed more suitable. Even after a postmortal interval of 168 hours it was possible to differentiate reliably damaged myocytes with fibrinogen deposits from intact muscle fibres, where fibrinogen deposits were not observed.