Case of the Month:

Deborah Carr – Philips R&D Innovation Center

Abstract

Cell injury definition^*:
Reversible or irreversible metabolic and morphological changes in cells

Causes include: physical; environmental - chemical, radiation; hypoxia, microbiologic, immunologic, nutritional

^* Queens University Belfast

Case history

A 55-year-old-man on irregular treatment for hypertension for the last 5 years presented with complaints of increasing breathlessness. 

Upon examination, pulse was 90/min, Blood Pressure (BP) 160/110 mmHg and there was mild  bilateral pedal edema.

Apex beat was 2cm lateral to the midclavicular line in the 5th intercostal space.

Despite treatment over the next three months, BP was poorly controlled and one day while climbing stairs he had acute chest pain, collapsed and died.

Case Presentation

This is an image of the heart on post-mortem examination.

Discussion

• Identify the pathologic change. Which chamber of the heart is affected and why?
• What is cause of the pathophysiologic change?
• Correlate the patient's symptoms and signs with this change.

Study the histology slides provided in the link and review the below;

• Describe the change in the myocardial cells indicated in the annotations (compare with normal cardiac myocytes)
• What is the response of the body to this change?
• Correlate the pathology with the patient's symptoms and signs.