Heart

Author: Mikael Häggström

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation

Presentations

• Heart autopsy

• Autopsy of myocardial infarction

• Heart valve

Gross processing

Heart specimens are generally not inked.

Basic microscopic screening

Generally check for signs of myocardial infarction. Further information: Autopsy of myocardial infarction

Common findings

• Myocardial lipofuscin reflects normal ageing rather than any cardiac pathology,[1] and does not need mentioning in the elderly.
  Myocardial lipofuscin reflects normal ageing rather than any cardiac pathology, and does not need mentioning in the elderly.
• Ruptured intercalated discs. Further information: Ruptured intercalated discs
  Ruptured intercalated discs. Further information: Ruptured intercalated discs
• Fibrosis. Further information: Myocardial fibrosis
  Fibrosis. Further information: Myocardial fibrosis
• Myocardial hypertrophy (in right image, compared to normal at left).
  Myocardial hypertrophy (in right image, compared to normal at left).
• Rectangular "Boxcar" nuclei: Look for myocardial hypertrophy, especially when enlarged. Otherwise, ruptured intercalated discs can cause square shaped nuclei.
  Rectangular "Boxcar" nuclei: Look for myocardial hypertrophy, especially when enlarged. Otherwise, ruptured intercalated discs can cause square shaped nuclei.

Other conditions to look for

• Giant-cell myocarditis, with multinucleated giant cells.
  Giant-cell myocarditis, with multinucleated giant cells.
• Lymphocytic myocarditis (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations.
  Lymphocytic myocarditis (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations.

Main page

• Main page of Patholines