Topic: Rheumatic and Ischemic heart disease
Question: Describe the autopsy findings in lungs and heart in a 40-year-old male with longstanding rheumatic heart disease with mitral stenosis.
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Autopsy findings in the lungs and heart of a 40-year-old male with longstanding rheumatic heart disease and mitral stenosis would likely show:
In the lungs:
– Pulmonary edema: Fluid buildup in the lungs due to congestive heart failure as a result of the mitral stenosis. This causes swollen lung tissues and frothy pink fluid in the airways.
– Pleural thickening: Thickening of the pleura lining the lungs due to long-term congestion and fluid buildup.
– Pulmonary arterial hypertension: High blood pressure in the pulmonary arteries due to the pressure overload from the mitral stenosis. This can lead to right ventricular hypertrophy.
In the heart:
– Mitral valve thickening and fibrosis: The mitral valve leaflets and chordae tendineae will show thickening, calcification and fibrosis due to the rheumatic damage. This narrows the mitral orifice and obstructs blood flow.
– Left atrial enlargement: The left atrium will be dilated and enlarged due to the pressure overload from the mitral stenosis.
– Right ventricular hypertrophy: The right ventricle will show thickened walls to compensate for the increased workload from pulmonary arterial hypertension.
– Possible atrial and/or ventricular thrombi: Blood clots may form in the enlarged left atrium or ventricles due to stasis of blood flow.
– Coronary artery atherosclerosis: Common in patients with longstanding rheumatic heart disease, contributing to the cardiac dysfunction.
So in summary, the autopsy findings would reflect the effects of longstanding valvular disease, congestive heart failure and pulmonary hypertension due to rheumatic mitral stenosis.
