A 54-year-old male presents with severe substernal chest pain. An ECG confirms a myocardial infarction. Which of the following intracellular changes characterizes the transition from reversible to irreversible injury in his cardiomyocytes?
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Correct answer: Severe mitochondrial swelling with amorphous densities
While mild mitochondrial swelling is reversible, the presence of large, flocculent, amorphous densities in the mitochondrial matrix indicates irreversible injury. These densities represent denatured proteins and lipids that signify a permanent loss of oxidative phosphorylation.
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