Spectrum of Histopathological Changes in Ischemic Heart Disease: An Autopsy Study

ABSTRACT

Background: cardiovascular disease comprising of mostly ischemic heart disease and stroke are leading cause of death worldwide. WHO estimates that India accounts for just over a fifth of these deaths. A thorough autopsy under expert supervision and histomorphological examination of heart plays an essential part to confirm the cause of death. Aims and objectives: This study was conducted to study the spectrum of histopathological changes in ischemic heart disease. Material and methods: A retrospective study of 252 cases of formalin fixed heart specimen was undertaken in the Department of Pathology, Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh. Out of 252 specimen, 32 specimen of heart showed autolytic changes and hence their histomorphological findings were not included in the study. A detailed gross and microscopic examination was performed, and findings were correlated with available clinical data to establish the cause of death. Result: Atherosclerosis was the most common lesion found in 124 cases (64%) followed by medial hypertrophy in 56 cases (28%) and intimal hyperplasia in 46 cases (23%). Other frequent findings were disruption of myocardial architecture 44 cases (22%) and patchy interstitial fibrosis 47 cases (23.5%). Also seen was presence of collateral formation in 39 cases (19.5%) and recanalization in 22 cases (11%). Microthrombi in circulation was seen in 27 cases (13.5%). These cases could have been the undiagnosed covid patients. Fibromuscular dysplasia was seen in 12 cases (6%) and thickening of pericardial fat in 10 cases (5%). Fibrous cap formation was seen in 7 cases (3.5%) and transmural inflammation in 12 cases (6%). Other less common findings were presence of Lines of Zhan in 7 cases (3.5%), Giant cell arteritis in 2 cases (1%) and dissection of aorta in 2 cases (1%). Conclusion: Atherosclerosis was found out to be the most common lesion responsible for causing mortality.