Cardiovascular Pathology

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• Cardiovascular Pathology
• Case Discussion
• Session 2

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• Case 01
• 25 years, Female 7 months amenorrhoea
• Progressive breathlessness Clinical features of
  severe aortic regurgitation
• Emergency operation performed Aortic valve
  replacement Bentalls procedure
• Section from ascending aorta

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• Case 2
• 23 years, Male
• Fever with chills for a week, accompanied by
  increasing shortness of breath, pain in abdomen,
  decreased urine output streaky hemoptysis
• Blood pressure of 156/100 mmHg
• Clinical impression Acute febrile illness
  (leptospiral) with acute renal failure, acute
  lung injury and hypertensive left ventricular
  failure
• At autopsy, suppurative to hemorrhagic
  pericarditis with loose bodies Section from the
  loose body

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• Case 3
• 32 years, Female
• Dyspnea on exertion for a long time with
  progression since the past two years, accompanied
  by palpitation syncopal attacks
• Clinical diagnosis Aortic stenosis with
  regurgitation
• Aortic valve replacement

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• Case 4
• 25 years, male
• Came to the hospital to visit a relative
• Sudden collapse died
• No other history available

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• Case 4
• Marked cardiomegaly (weight 450 gm)
• Hypertrophy of all chambers
• Myocardium pale yellow firm
• Valves coronaries normal
• Gross diagnosis ? Amyloidosis, ? HCM
• No other positive finding gross or micro

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RV
LV
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RV
LV
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• Case 5
• 35 years, Female
• Atypical chest pain high grade fever with
  chills for 2
• days
• Past history Facial puffiness, joint swelling
  oral
• ulcers, a year back
• Died a few days later
• Autopsy Heart with multiple mural thrombi in
  RA, RV
• LV and warty vegetations on tricuspid
  mitral
• valves

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MV
AV
LV
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MV
MV
LV
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LV
RV
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MV
Vegetation
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• Case 6
• 11 years, Female
• Diagnosed case of rheumatic mitral regurgitation
• Repeated hospitalizations in the past for cardiac
  failure
• Collapsed in the out-patient department after
  penicillin prophylaxis
• Died within three hours of admission

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• Case 7
• 37 years, Male
• Operated in a private nursing home for bilateral
  hydrocele
• Chest X-ray - Cardiomegaly pulmonary congestion
• An hour after the operation, he developed
  giddiness, excessive perspiration and cyanosis
  EKG T-wave changes in leads V1 to V6
• Death within 45 minutes Referred to our
  institute for a medicolegal autopsy
• Section from aorta right coronary artery

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Aorta
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Right Coronary Artery
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