ABSTRACT
A case of extrinsic nonvalvular mitral obstruction due to a large epicardial hematoma in a patient with rheumatoid constrictive pericarditis is described. The patient had longstanding rheumatoid arthritis and a mitral diastolic murmur developed. Mitral obstruction was confirmed by a hemodynamic study. Coronary angiography and left ventricular angiography showed severely diseased coronary arteries and a distorted left ventricular cavity. Autopsy demonstrated rheumatoid arthritis, a normal mitral valve, thickened pericardium, and epicardial hematoma surrounding both ventricles at the atrioventricular junctional level.
Subject(s)
Hematoma/complications , Mitral Valve/pathology , Pericardial Effusion/complications , Pericarditis, Constrictive/complications , Arthritis, Rheumatoid/complications , Heart Valve Diseases/etiology , Humans , Male , Middle AgedABSTRACT
A 76-year-old man without apparent dementia met pathologic criteria at autopsy for Alzheimer's disease, which included a maximum senile plaque density greater than 15 per square millimeter of neocortex. Despite hippocampal sclerosis, changes typical of Alzheimer's disease were not found in this region or in basal forebrain. Choline acetyltransferase activity in hippocampus, septum, and parietal cortex was normal.
