This hypertensive female patient of 69 years gave a 12 hour history of chest pain radiating down both arms. She died two days following admission.
The specimen comprises three transverse sections of heart which display the ventricles. In the upper specimen the left ventricle is on the right hand side and the branches of the left coronary artery show yellow crescentic atheromatous plaques and overlying occlusive thrombi. The lower two specimens show the left ventricular muscle in which there is a large irregular haemorrhagic area in the postero-lateral and apical regions. From the back, thrombus is seen attached to the overlying endocardium at the apex.
The pericardium was full of blood, the left ventricle having ruptured posteriorly. This is an example of coronary thrombosis, myocardial infarction and left ventricular rupture leading to tamponade; ie: compression of the venous inflow into the heart by rising intrapericardial pressure.