Recent Myocardial Infarction

Clinical History

This 59 year old man who had a past history of angina pectoris, was admitted to hospital following an episode of severe retrosternal crushing chest pain associated with nausea and some vomiting. He died 24 hours after admission.

Pathology

This is a transverse section through both ventricles. There is left ventricular hypertrophy and probable left ventricular dilatation. There are several foci of white, slightly depressed, glistening scars within the left ventricular muscle. In addition, there is an extensive area of patchy congestion and mottling of the left ventricle, particularly in the posterior-lateral, posterior and septal areas.

Diagnosis

Heart: Patchy myocardial fibrosis: evidence of recent extensive posterior- lateral and septal myocardial infarction.

Questions

? What are the causes of ischaemic heart disease? ? Do you understand the current theories of the pathogenesis of atherosclerosis?