HISTOPATHOLOGY OF

THE HEART

I. practical training

3rd year General Medicine

Acute myocardial infarction

Acute myocardial infarction

Kopie

1 coagulative necrosis subendocardialy

2 hyperemic layer 3 normal myocard 4 epicard

1

2

2

3

4

1 1

Acute myocardial infarction

Recent myocardial infarction

Recent myocardial infarction

Older myocardial infarction

Postinfarction scar of the myocard

Postinfarction scar of the myocard

Diphtheric myocarditis

Diphtheric myocarditis

Rheumatic myocarditis

Rheumatic myocarditis

Bacterial endocarditis

1 vegetation

2 atrial endocard

3 papillary muscles

4 myocard

1 1

1

1

2

3

3

4

Bacterial endocarditis

1 vegetation

2 atrial endocard

3 papillary muscles

4 myocard

1

2

3

4

4

Bacterial endocarditis – vegetation

1 valve

2 vegetation

1

1

2

2

1

2

Bacterial endocarditis – vegetation

1 bacterial colonies

2 thrombus

3 erytrocytes and leukocytes

1

1

1 2

2

3

3

Bacterial endocarditis – vegetation

1 bacterial colonies

2 thrombus

1

1

1

1

2

Bacterial endocarditis – valve

1 bacterial colonies

2 valve infiltrated by neutrophils

1

2

2

Bacterial endocarditis – valve

Infiltration by neutrophils

Acute fibrinous pericarditis

Fibrinous pericarditis

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Fibrinous pericarditis

1 Epicard

2 Fibrin

3 Myocard

1

2

3

Fibrinous pericarditis

1 Masses of fibrin

2 Epicard

1

2

Tuberculous pericarditis

Rhabdomyoma of the heart

Myxoma

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Myxoma

Myxoma

1 spindle and stellar cells

2 stroma with mucus

1

2

1

Cardiomyopathy: functional patterns and causes (normal ejection fraction 50-65%)

functional pattern

ejection fraction of

left ventricle

mechanism of cardial failure

causes

dilatated (hypertrophy,

dilatation) < 40%

systolic dysfunction

Idiopathic, alcohol, peripartum,

genetic changes, myocarditis,

hemochromatosis, chronic anemia,

doxorubicin (adriamycin), ssarcoidosis

obstructive=hyper trophic

(hypertrophy, without dilatation)

50-80% diastolic

dysfunction

idiopathic, genetic changes, Friedrich ataxia,

storage disease, infants of diabetic mothers

restrictive (normal size of

heart, dilatation) 45-90%

diastolic dysfunction

idiopathic, amyloidosis, radiation-induced fibrosis

Robbins et all: Pathologic basis of disease, Philadelphia, 1999

Erdheim’s cystic medionecrosis

Atherosclerosis

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Aorta Conorary artery

Atherosclerosis

Atherosclerosis

Atherosclerosis – coronary artery

1 narrowed lumen of artery

2 atherosclerotic plate in arterial

intima

3 arterial wall with fine intima

4 adipose tissue of epicard

1

2

2

3

3

4

4

Atherosclerosis

1 atherosclerotic plate in arterial

intima

2 lumen of artery

3 arterial media

4 arterial adventitia

5 vascularisation of intima

2

1

3

1

4

5 1

1

Atheroclerosis – fibrous plaque

1 fibrous plate in arterial

intima

2 lumen of artery

3 arterial media

4 arterial adventitia

1

2

1

3

3

4

1

Cholesterol crystals

Foamy cells

1 nuclei of lipophages

2 adipose substances

phagocyted in cytoplasm

1

1

2

2

Intimal capillaries

1 arterial lumen

2 arterial media

3 vascularisation of intima

4 cholesterol crystals

3

1

4

4

2

Atherosclerosis – complication

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1 bleeding in plate

2 atherosclerotic plate

3 poststenotic dilatation of artery

1

2

3

Atherosclerosis – complication – thrombosis

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Arterial lumen filled up with thrombus

Atherosclerosis

complications

Atherosclerosis – cholesterol crystals, calcification

Nephrosclerosis

Nephrosclerosis

Nephrosclerosis

Polyarteritis nodosa

1 arterial lumen with thrombus

2 deposits of fibrin

3 mixed inflammatory infiltrate

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1

2

3

2

3

3

3

Polyarteritis nodosa – detail

1 arterial lumen with thrombus

2 deposits of fibrin

3 mixed inflammatory infiltrate

1

2

3

3

Polyarteritis nodosa

1 arterial lumen with thrombus

2 deposits of fibrin

3 mixed inflammatory infiltrate

1 2

3

3