pathology of the heart  

outlines

- normal valve

- normal aortic valve

- acute rheumatic fever

- infective endocarditis

- normal heart chamber

- abnormal heart chambe

- cardiomyopathyr

 

normal valve

- normal mitral valve

- normal aortic valve

normal mitral valve

 

normal aortic valve

acute rheumatic fever

Mitral valve

- rheumatic verrucous endocarditis showing continuous row of pin-head sized tan-colored vegetation at the line of closure of both the AML, PML

- the MacCallum's patch seen as a roughened area over the posterior wall of LA

- healing of acute rheumatic fever has produced thick and leathery AML and PML, chordal thickening, and fusion of the commissural aspects

- ridge-like discontinuous thickening of the lines of closure due to healing of rheumatic vegetations

- classic "fish-mouth" or "button-hole" deformity of mitral valvular orifice

- opened out LV inflow tract in the same case hilights the severity of valvular and subvalvular pathology

- LV aspect showing a funnel-shaped mitral valve with extreme chordal shortening and fusion with near-total obliteration of interchordal space

infective endocarditis

- acute endocarditis

- subacute endocarditis

- nonbacterial thrombotic endocarditis (NBTE)

- histology of infective endocarditis

acute endocarditis

 

tricuspid valve mitral valve aortic valve

- bulky vegetation on a surgically excised valve leaflet

- few residual chordae tendineae seen (arrow)

- endocarditis with large vegetation on the atrial aspect of the valve with the unremarkable chordae

(infective endocarditis)

- surgically excised valve with a large vegetation on the atrial aspect of the valve

- endocarditis on congenitally aortic valve with extensive cuspal destruction and ring abscess

- healed endocarditis : the gapign hole with the fibrous rim, and a small strand at the free edge.

- the hole is at the line of closure. The affected valve is the left cusp

- the right noncoronary cusp (immediate to the left in this image) demonstrates a small, multichanneled fenestration at the commissure, immediately adjacent to similar fenestrations in the left coronary cusp.

 

 

subacute endocarditis

- large, friable vegetations

 

nonbacterial thrombotic endocarditis (NBTE)

- small thrombotic vegetations along the line of closure of the mitral valve leaflets

 

histology of infective endocarditis

- arrows point to the areas of acute inflammation with valve destruction

- areas of acute inflammation and fibrin deposition

- surface of valve with leaflet with fibrin and macrophages (arrows), which are seen in the acute and subacute phases of inflammation.

- bioprosthetic valve endocarditis : bacterial coloniesw with underlying valve tissue is collagenous, derived from bovine pericardium with large fibrin vegetation (white arrow)

- valve destruction with necrosis, bacterial clump

normal heart chamber

normal heart chamber

abnormal heart chamber

- left ventricular hypertrophy

- right ventricular hypertrophy

 

left ventricular hypertrophy

- preesure-overloaded heart has an increased mass, a thick wall, and a smaller lumen

- the volume-overloaded heart has an increased mass, larger lumen, and enlarged size, but a normal wall thickness

 

right ventricular hypertrophy

- the right ventricle is markedly dilated and hypertrophied with a thickened free wall and hypertrophied trabeculae

cardiomyopathy

- dilated cardiomyopathy

- arrhythmogenic right ventricular cardiomyopathy

- hypertrophic cardiomyopathy

dilated cardiomyopathy

- four-chamber dilatation and hypertrophy are evident with a small mural thrombosis can be seen at the apex of the left ventricle

 

arrhythmogenic right ventricular cardiomyopathy

- the right ventricle is markedly dilated with focal, almost transmural replacement of the free wall by adipose tissue and fibrosis.

- the left ventricle has a grossly normal appearance in this heart.

 

hypertrophic cardiomyopathy

- hypertrophic cardiomyopathy with assymmetric septal hypertrophy

- the septal muscle bulges into the left ventricular outflow tract, giving rise to a banana-shaped.

- ventricular lumen and the left atrium is enlarged.

- the anterior mitral leaflet has been moved away from the septum to reveal a fibrous endocardial plaque.