[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Hemodynamic disorders](https://durgical.com/en/general-pathology/#a-hemodynamics) › Infarction: red vs white, and what decides the damage

[General pathology](https://durgical.com/en/general-pathology/) · [Hemodynamic disorders](https://durgical.com/en/general-pathology/#a-hemodynamics)

# Infarction: red vs white, and what decides the damage

- Lesion

An infarct is an area of tissue killed by lack of blood. It is white in solid organs with one artery and red in loose tissue or with a dual supply.

Updated 2026-11-01

## Key points

- White infarct: arterial occlusion in a solid organ with end-arterial supply (heart, kidney, spleen).
- Red infarct: venous occlusion (testicular or ovarian torsion), loose tissue, dual supply (lung, small bowel) or reperfusion.
- Wedge shape: the apex points to the blocked vessel and the base to the organ surface.
- Coagulative necrosis in almost every organ; liquefactive in the brain.
- What decides the damage: vascular anatomy, speed of occlusion, tissue vulnerability and blood oxygen content.

## What it is

An infarct is an area of ischemic necrosis, almost always caused by occlusion of an artery (thrombus or embolus) and less often of a vein. It is white (anemic) when an end artery is blocked in a solid organ, such as the heart, kidney or spleen, and red (hemorrhagic) when there is a dual supply, loose tissue, venous occlusion or reperfusion. The final damage depends on the anatomy of the supply, the speed of the occlusion, the tissue’s sensitivity to hypoxia and the oxygen in the blood.

## Key facts

- The liver (hepatic artery and portal vein) and the hand (radial and ulnar arteries) seldom infarct because of their dual supply.
- Anemia, carbon monoxide poisoning or heart failure worsen any infarct by lowering blood oxygen.
- A septic infarct, from an infected embolus, turns into an abscess.
- In sickle cell disease repeated splenic infarcts shrink the spleen into a fibrous remnant (autosplenectomy).

## Step by step

- An artery is blocked and the downstream tissue is left without oxygen.
- The most sensitive cells die first: neurons in minutes, myocytes in under an hour, fibroblasts in hours.
- The dead zone takes shape over hours; in red infarcts it fills with blood.
- Acute inflammation reaches the edge within one or two days.
- Macrophages clear the dead tissue and granulation tissue appears.
- A fibrous scar forms; in the brain a cyst ringed by gliosis is left.

## Type of infarct by organ

| Organ | Type | Why |
| --- | --- | --- |
| [Heart](https://durgical.com/en/conditions/myocardial-infarction/) | White (coagulative) | End-artery coronaries; dense myocardium |
| Kidney and spleen | White, wedge-shaped | End arteries in a solid organ |
| [Brain](https://durgical.com/en/conditions/ischaemic-stroke/) | Pale and liquefactive; may turn hemorrhagic on reperfusion | Tissue rich in lipid and enzymes, poor in stroma |
| [Lung](https://durgical.com/en/conditions/pulmonary-embolism/) | Red | Dual supply and spongy tissue |
| [Small bowel](https://durgical.com/en/conditions/acute-mesenteric-ischaemia/) | Red | Collateral arcades and loose tissue; also from mesenteric venous thrombosis |
| [Torsed testis](https://durgical.com/en/conditions/testicular-torsion/) | Red | The vein is blocked first and the artery keeps filling the organ |

## Memory aid

Single artery, pale infarct; blood that comes back or cannot leave, red infarct.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is a pulmonary infarct red?

Because the lung has a dual supply and loose tissue: bronchial blood keeps reaching the necrotic zone.

## Which type of necrosis does a cerebral infarct produce?

Liquefactive necrosis; the tissue softens and ends as a cystic cavity.

## Why does testicular torsion produce a hemorrhagic infarct?

Because torsion first blocks the thin-walled veins while the artery keeps bringing blood in.

## Besides the occlusion, which four factors decide the size of the damage?

The anatomy of the supply, the speed of the occlusion, the tissue’s vulnerability to hypoxia and the blood’s oxygen content.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/general-pathology/infarction-red-vs-white-and-what-decides-the-damage/)

## Related

- [Patterns of necrosis: coagulative, liquefactive, caseous, fat, fibrinoid, gangrenous](https://durgical.com/en/general-pathology/patterns-of-necrosis-coagulative-liquefactive-caseous-fat-fibrinoid-gangrenous/)
- [The myocardial infarct over time: what the pathologist sees from hours to months](https://durgical.com/en/general-pathology/the-myocardial-infarct-over-time-what-the-pathologist-sees-from-hours-to-months/)
- [Watershed areas and the organs most sensitive to ischemia](https://durgical.com/en/general-pathology/watershed-areas-and-the-organs-most-sensitive-to-ischemia/)
- [Hypoxia, ischemia and reperfusion injury](https://durgical.com/en/general-pathology/hypoxia-ischemia-and-reperfusion-injury/)
- [Systemic (arterial) thromboembolism](https://durgical.com/en/general-pathology/systemic-thromboembolism/)
- [Granulation tissue and scar formation](https://durgical.com/en/general-pathology/granulation-tissue-and-scar-formation/)

## Related conditions

- [Myocardial Infarction (Heart Attack)](https://durgical.com/en/conditions/myocardial-infarction/)
- [Ischaemic stroke](https://durgical.com/en/conditions/ischaemic-stroke/)
- [Pulmonary embolism](https://durgical.com/en/conditions/pulmonary-embolism/)
- [Avascular necrosis of the femoral head](https://durgical.com/en/conditions/avascular-necrosis-of-the-femoral-head/)
- [Testicular torsion](https://durgical.com/en/conditions/testicular-torsion/)
- [Acute mesenteric ischaemia](https://durgical.com/en/conditions/acute-mesenteric-ischaemia/)
- [Sickle cell disease](https://durgical.com/en/conditions/sickle-cell-disease/)
- [Central retinal artery occlusion](https://durgical.com/en/conditions/central-retinal-artery-occlusion/)
- [Ischaemic colitis](https://durgical.com/en/conditions/ischaemic-colitis/)

## Elsewhere in DurgiPedia

- [Cell injury, apoptosis and necrosis](https://durgical.com/en/histology/cell-injury-apoptosis-and-necrosis/)
- [Coronary circulation and myocardial ischemia](https://durgical.com/en/physiology/coronary-circulation-and-myocardial-ischemia/)

[← All of general pathology](https://durgical.com/en/general-pathology/)

Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Heart attack: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000195.htm) (MedlinePlus, US National Library of Medicine, 2024); [Stroke: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000726.htm) (MedlinePlus, US National Library of Medicine, 2025); [Ischemic Stroke](https://www.ncbi.nlm.nih.gov/books/NBK499997/) (StatPearls (NCBI Bookshelf), 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/general-pathology/infarction-red-vs-white-and-what-decides-the-damage/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/infarction-red-vs-white-and-what-decides-the-damage/