Ten days prior to death this 54 year old male smoker experienced a sudden retrosternal, stabbing chest pain radiating to the left elbow. There were no associated features and it persisted for 20 minutes.
This heart has been sectioned horizontally into 1.5 cm thick slices and has been mounted to display the cut surfaces. The heart appears enlarged and there is biventricular dilatation. The posterior and lateral walls of the left ventricle show the presence of a recent myocardial infarct with extensive subendocardial pallor surrounded by a zone of hyperaemia. The infarct extends into the antero-lateral wall of the left ventricle, and into the posterior wall of the right ventricle. There is no overlying pericarditis or mural thrombus formation. This appearance is consistent with an infarct of approximately one week's duration.