Unless I’ve misunderstood my husband’s doctors, when he had a heart attack some of his heart muscle died from lack of oxygen.
Why doesn’t that dead material have to be removed some way? Doesn’t it rot or putrefy or something nasty?
It turns into scar tissue. This in and of itself is not necessarily bad but if enough of the heart tissue is damaged, the heart is no longer able to pump effectively and can lead to heart failure. It doesn’t rot or putrefy because it is a presumably sterile environement
And said scar tissue can often balloon out and become a relatively inert part of the heart pump. Blood in said scar tissue may not circulate properly and form clots which travel and kill; the scarred area may turn into an aneurysm and rupture too. These are bad things to have happen.
The heart is supplied by multiple vessels, so plugging up one particular vessel doesn’t usually kill the muscle in that area so rapidly that it “rots.” It stops working and a teeny bit of oxygen oozes into it from surrounding tissue to let it heal. There is time for the body’s healing process to replace it with scar tissue.
On rare occasion, it does sort of rot and fall apart, and the result can be quite serious. As an examply, the wall between the chambers can sometimes infarct and the wall will simply rupture within a couple of days. Another example is when the little muscles that hold valve leaflets rupture. I’ve seen a few of these over the years but they are quite rare. As mentioned by Qadgop if a large enough area is injured that part of the heart doesn’t contract properly. Over time it can stretch and thin out, worsening the pumping efficiency further.
Good reading on heart attacks can be found here
IIRC, from my one viewing of a ‘live’ autopsy, lo these many years ago…
(I’ll spoiler it. It’s not all that horifying, but, to give the reader the option of knowing what a heart with old infarcts looks like from the POV of an autopsy.)
The autopsy I was able to watch was one of the most fascinating things I’ve seen. Most of the “large-scale” stuff was done by a tech - actually, there were two working simultaneously one two different cadavers, but I only concentrated on one. The tech did the major organ removal / measuring, while the MD did the tissue sampling. I was watching the tech’s work mostly, but the MD called me over when he got to the cause of death. He had some tissue samples from the heart muscle and showed me the (numerous) black areas that represented old infarcts. He then showed me the one, rather large, white area of the newest and finally lethal infarct.
So, to summarize, a person can certainly live with numerous infarcted areas of the the heart. 5 out of 5 doctors surveyed do not recommend it though…
My mom had a heart attack several years ago. Her cardiologist told me recently, before she had a pacemaker/defibrillator installed, that the part of her heart muscle that was ‘dead’ from the heart attack has turned into something akin to a dried up piece of leather.
Maybe I heard him wrong, though.
My brother had part of his heart die from his heart attack/heart failure last year. I believe this made the one valve not close correctly and there was a chance he would need surgery for this. Hasn’t happened yet. But they certainly didn’t seem concerned about the dead tissue.