Aortic stenosis microscopic pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Aysha Aslam, M.B.B.S[2]

Overview

Common findings on microscopic pathologic evaluation in the patient with aortic stenosis include left ventricular hypertrophy and calcific degneration of the aortic valve.

Microscopic features of aortic stenosis

  • The calcified aortic stenosis shows pink amorphous material around the calcific foci indicating deposition of calcium.[1]
  • The microscopic features of congenital and calcific aortic stenosis include the areas of fibrosis, thickening, fat cell infiltration and elastosis.[1]

An Autopsy Report

A 68-year-old man initially sought medical advice five years prior to his death. His symptoms at that time were exercise intolerance and occasional peripheral edema. He gave a history of a heart murmur that was diagnosed 25 years ago during an employment physical. No follow up care had been given for this murmur.

The patient's terminal admission was for signs of severe heart failure - the patient had marked peripheral edema and shortness of breath and chest x-ray revealed significant cardiac enlargement and pulmonary edema with bilateral pleural effusions. He sustained a cardiac arrest shortly after admission and could not be resuscitated.

Autopsy Imaging Findings

Autopsy disclosed a markedly enlarged heart weighing 650 grams and having dilated chambers. The aortic valve was calcified and showed evidence of stenosis and insufficiency. The coronary arteries were narrowed 60 to 70% by atherosclerosis. No acute coronary occlusions were found and there was no evidence of myocardial infarction.

References

  1. 1.0 1.1 Towler DA (2013). "Molecular and cellular aspects of calcific aortic valve disease". Circ Res. 113 (2): 198–208. doi:10.1161/CIRCRESAHA.113.300155. PMC 4057916. PMID 23833294.


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