Case Scenario: Autopsy

History

This man died suddenly at home. He had a history of raised blood pressure and congestive cardiac failure for which he took anti-hypertensives, digoxin and diuretics. Following a bout of 'flu, he took to his bed. After 3 days of bed rest, he decided to 'get up' but immediately collapsed back onto the bed. He was dead when the paramedics arrived. At post-mortem the immediate cause of death was found to be massive pulmonary embolism.

The main pulmonary arteries have been opened to reveal a mass of coiled ante-mortem thrombus and blood clot. What is the likely source of origin of the thrombus (Diagnosis 1)? He also had signs of congestive cardiac failure in the lungs and liver at post-mortem. What do you think they showed? The coronary arteries showed severe narrowing by atherosclerosis but no occlusion. On slicing the heart, the pathologist saw some irregular pale areas in the myocardium. The section is from the diseased myocardium. What do you think it shows (Diagnosis 2)?

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