Right ventricular rupture

A case from Dr Agbamu

A 99 year old female who suffered a cardiac arrest at home and whose family “requested a PM be conducted to establish the exact COD.”

Right Ventricular Rupture3

He says that he thought this was going to be amyloid, but the Congo red is negative, and the Masson’s trichrome suggests that the material is collagen.

The underlying questions are,

  1.  Is “diffuse myocardial fibrosis” a recognised pathological diagnosis (as opposed to a description).
  2. If it is, what is the cause of “diffuse myocardial fibrosis”. Is it a consequence of senescence? Is the aortic stenosis (felt was minor) enough to account for it?
  3.  Is there another diagnosis?

3 thoughts on “Right ventricular rupture”

  1. Is it worth repeating the amyloid stain? This really looks like amyloid.

  2. complex case with various questions
    I agree that the material looks like amyloid. I would get repeat/another centre to do the stain again….and would even get electron microscopy as it looks so good for amyloid. one has, of course, to remember that amyloid is commoner as the age rises…..
    the heart muscle remodelling will likely reflect the aortic stenosis and the age of the individual (often a degree of LV systolic dysfunction). The issue of the rupture might be reflective of resuscitation attempts, but I would have to expect weakened are as substrate (eg, infarct/amyloid).
    the brain medulla artery I think is also amyloid.

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