Autopsy revealed intramyocardial dissecting haematoma in the subacute phase of an anteroseptal myocardial infarction

Figures

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  Figure 1. (A) Macroscopic figure of the serially sectioned heart. The anterior wall is thinned due to a myocardial infarction that occurred 3 weeks previously. The ventricular septum maintains its thickness despite the old infarct because it contains a massive haematoma (white arrow) in the core. (B) Haematoxylin–eosin stain represents a newly fresh large haematoma in the interventricular septum shown by the red-marked dashed square in (A). The scale bar represents 1 mm. (C) Staining with an anti-desmin antibody revealed that inside the viable myocyte layer, there is an unstained zone of organized granulation tissue corresponding to the infarct 3 weeks prior (black double arrow). Between the unstained central area of the haematoma and the organized granulation tissue, the less but apparently stained area indicates a fresh necrotic myocyte layer (black arrowhead). (D) Enlarged image of the area represented by the dashed black square in (B). The border between the fresh infarct myocyte layer and the haematoma. Wavy and necrotic myocytes without nuclei are observed in the upper left. The haematoma is adjacent to the fresh necrotic lesion. The scale bar represents 100 μm.