Petechial haemorrhagic transformation has traditionally been referred to by pathologists as "red softening" in contrast to the more common bland or anaemic infarct.
It is believed that haemorrhagic transformation occurs as a result of preserved collateral perfusion (from adjacent vessels/territories) or from reperfusion of infarcted tissues which have weakened vessels (i.e. from extravasation or diapedesis) 1. The former explains why haemorrhagic transformation is seen in patients with permanently occluded vessels. The latter accounts for the increased incidence in patients receiving therapies designed to increase re-perfusion rates.