CV pathology

Question 1

R Atrium

Answer 1

atrial appendage: broad attachment neck, blunt tip Internal features: - smooth sinus venarum connecting SVC&IVC - crista terminalis with perpendicular pectinate trabeculae - fossa ovalis with distinct limbus - coronary sinus

Question 2

Answer 2

Right atrium

Question 3

RV

Answer 3

• inlet is tricuspid valve
• multiple small papillary muscles
• coarse trabecular zone
• muscular infundibulum (outlet)
- trabecula septomarginalis
- lack of fibrous continuity between atrioventricular valve (tricuspid) and arterial valve (pulmonary)

Question 4

LA

Answer 4

• atrial appendage
- narrow attachment neck
- hooked tip
• internal features
- pectinate muscles confined to atrial appendage
- smooth pulmonary vein component
- irregular flap valve or plaque of foramen ovale

Question 5

LV

Answer 5

• inlet is mitral valve with 2 distinct papillary muscles
• fine trabecular zone
• smooth subarterial septum
• fibrous continuity of atrioventricular valve (mitral) and
arterial valve (aortic)

Question 6

Answer 6

perimembranous VSD

Question 7

Answer 7

muscular (probe) VSD and perimembranous VSD

Question 8

Answer 8

complete AVSD (often seen in Down’s syndrome)

Question 9

Answer 9

TOF

Question 10

Answer 10

transposition of the great arteries

Question 11

Answer 11

Truncus arteriosus

Question 12

Answer 12

Hypoplastic left heart

Question 13

Answer 13

Endocardial fibroelastosis

Question 14

Answer 14

MI

anterior wall rupture

few days after event

Question 15

Answer 15

acute MI

extensive hemorrhage secondary to capillary ischemia + necrosis

loss of myocyte nuclei

Question 16

Answer 16

very acute MI

extensive hemorrhage secondary to capillary ischemia and necrosis

loss of myocyte nuclei

Question 17

Answer 17

MI

infiltration of PMN

Question 18

Answer 18

MI

PMN infiltration

loss of myocyte nuclei

Question 19

Answer 19

hemorrhage into an atherosclerotic plaque in a CA

subsequent thrombus of lumen leading to acute MI

Question 20

Answer 20

old (white) MI

small ventricular aneurysm with mural thrombus

scarred wall contracts, not able to withstand force –> aneurysm

mural thrombus from acute MI

Question 21

Answer 21

old infarct with residual viable myocardium

necrosed tissue appears white (fibrosis)

Question 22

Answer 22

Severe aortic stenosis

Question 23

Answer 23

AAA (bulge)

Question 24

Answer 24

LVH

(small infarct - microscopic)

Question 25

Answer 25

White part - old infarctions

thin area could lead to aneurysms

Question 26

Answer 26

lung with edema

minimal hemorrhage typical of heart failure

Question 27

Answer 27

LVH

Question 28

Answer 28

Aortic valve with stenosis

possible vegetations

Question 29

Answer 29

vegetation on a valve

bacterial endocarditis

Question 30

Answer 30

black arrow = normal valve

red arrow = vegetation

distorted valve, partially destroyed by bacterial colonies and inflammatory cells

Question 31

Answer 31

normal valve

Question 32

Answer 32

bacterial vegetations

valve distorted, partially destroyed by bacterial colonies and inflammatory cells

Question 33

Answer 33

bacterial colonies in endocarditis

Question 34

Answer 34

aortic dissection

dissecting aneurysm

green - original channel

red - new channel