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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?. Right Ventricle Left Ventricle C. Anterior surface. Acute Myocardial infarction of left ventricle

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Cardiovascular Pathology I Case 1

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  1. Cardiovascular Pathology ICase 1 • 55-year old man with crushing chest pain radiating to the left shoulder

  2. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  3. Right Ventricle • 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.

  4. 4x objective

  5. Congested capillaries Acute inflammation 4x objective myocardium

  6. neutrophils Necrotic myocytes have lost nucei and cross-striations

  7. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  8. Acute Myocardial infarction of the anterior left ventricle and septum is delineated by an area of dark, red-brown hemorrhage P = posterior Heart has been fixed in formalin

  9. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  10. Acute Myocardial infarction Cross section of the left ventricle shows an extensive, circumferential acute myocardial infarction. The asterix points out the non-infarcted myocardium.

  11. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  12. Healed myocardial Infarction Cross section of the Heart (two halves):     A. Right Ventricle      B. Left Ventricle. Arrows point to healed myocardial infarction.

  13. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  14. Myocardial Infarction extending to the papillary muscle The arrow points to a partial rupture of the muscle. Asterix denotes mitral valve leaflet.

  15. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  16. 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 • Left atrium  • Mitral valve   • Left ventricle

  17. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  18. 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. • Left atrium  • Left ventricle • Longitudinal section of the heart

  19. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  20. 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

  21. Identify the organ, structures Describe the gross morphologic changes Diagnosis?

  22. Acute coronary artery thrombosis The artery is "bread loaved" (cut in serial section)

  23. calcifications media Intimal hyperplasia Thrombus RECENT THROMBUS of CORONARY ARTERY

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