Transcript Cardiovascular Pathology I Case 1

Cardiovascular Pathology I
Case 1
• 55-year old man with crushing chest pain
radiating to the left shoulder
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
A. Right Ventricle
B. Left Ventricle
C. Anterior surface
Acute Myocardial infarction of left ventricle
The mixture of pale myocardium (thin arrow) and hemorrhage (thick arrow) highlight
the infarcted tissue.
The asterix points out the non-infarcted myocardium.
4x objective
Congested capillaries
Acute inflammation
4x objective
myocardium
neutrophils
Necrotic myocytes have lost nucei and cross-striations
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
P = posterior
Heart has been fixed
in formalin
Acute Myocardial infarction of the
anterior left ventricle and septum is
delineated by an area of dark, redbrown hemorrhage
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
Acute Myocardial infarction
Cross section of the left ventricle shows an
extensive, circumferential acute myocardial
infarction.
The asterix points out the non-infarcted
myocardium.
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
Healed myocardial Infarction
Cross section of the Heart (two halves):
A. Right Ventricle
B. Left Ventricle.
Arrows point to healed myocardial infarction.
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
Myocardial Infarction extending to the
papillary muscle
The arrow points to a partial rupture of the
muscle.
Asterix denotes mitral valve leaflet.
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
A. Left atrium
B. Mitral valve
C. Left ventricle
Myocardial rupture
Longitudinal section of the heart.
The thick arrow points to the site of rupture of the apex of the left
ventricle. The rupture occured secondary to an acute transmural
infarction.
The thin arrows outline the pericardial sac which is filled with blood
Identify the organ, structures
Describe the gross morphologic
changes
Diagnosis?
A. Left atrium
B. Left ventricle
Longitudinal section of the heart
Large Apical Ventricular aneurysm
“C” represents the inlet to the aneurysm which contains
a laminated thrombus (*).
Notice the thin fibrotic wall (arrow) of the aneurysm.
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
Ventricular aneurysm
Longitudinal section of the heart through the
(A ) Aortic valve
(B) Left ventricle (half of the left ventritricle is folded back (*)
(C) Arrows delineate the thin, fibrotic wall of the aneurysm,
which contains red thrombus
Identify the organ, structures
Describe the gross morphologic changes
Diagnosis?
Acute coronary artery thrombosis
The artery is "bread loaved" (cut in serial section)
calcifications
media
Intimal
hyperplasia
Thrombus
RECENT THROMBUS of CORONARY ARTERY