IPLab:Lab 4:Chronic Passive Congestion - Revision history

Peter Anderson: /* Autopsy Findings */

2020-06-24T01:56:14Z

‎Autopsy Findings

Peter Anderson: /* Clinical Summary */

2020-06-24T01:56:06Z

‎Clinical Summary

Peter Anderson: /* Clinical Summary */

2020-06-24T01:55:24Z

‎Clinical Summary

Peter Anderson: /* Virtual Microscopy */

2015-09-16T19:17:48Z

‎Virtual Microscopy

Seung Park at 16:11, 3 January 2014

2014-01-03T16:11:10Z

Seung Park: /* Images */

2013-08-30T01:30:43Z

‎Images

Seung Park at 02:37, 22 August 2013

2013-08-22T02:37:00Z

Seung Park at 14:54, 21 August 2013

2013-08-21T14:54:41Z

Peter Anderson at 14:27, 21 August 2013

2013-08-21T14:27:17Z

Peter Anderson at 14:26, 21 August 2013

2013-08-21T14:26:58Z

← Older revision		Revision as of 01:56, 24 June 2020
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	At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.		At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.
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−	~~== Autopsy Findings ==~~
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−	At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.

	== Images ==		== Images ==

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 This 57-year-old male was hospitalized with a three-month history of a dry, hacking cough, dyspnea, and chest pain. He was diagnosed as having congestive heart failure. There was no evidence of myocardial infarction, but renal and hepatic functions were decreased. The patient developed refractory congestive heart failure and renal failure. The patient's cardiac index was marginal and he was classified as a having congestive cardiomyopathy. The patient had a cardiorespiratory arrest and died two months after admission.
- At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.
+At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.
 == Autopsy Findings ==

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 == Clinical Summary ==
-This 57-year-old male was hospitalized with a three-month history of a dry, hacking cough, dyspnea, and chest pain. He was diagnosed as having congestive heart failure due to viral myocarditis. There was no evidence of myocardial infarction, but renal and hepatic functions were decreased. The patient developed refractory congestive heart failure and renal failure. The patient's cardiac index was marginal and he was classified as a having congestive cardiomyopathy. The patient had a cardiorespiratory arrest and died two months after admission.
+ At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.
 == Autopsy Findings ==

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 == Virtual Microscopy ==
 <peir-vm>IPLab4ChronicPassiveCongestion</peir-vm>
 == Study Questions ==

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 File:IPLab4ChronicPassiveCongestion9.jpg|This is a gross photograph of the cut surface of a liver with chronic passive congestion (left) compared to the cut surface of a nutmeg (right).
 </gallery>
 == Study Questions ==

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 === Images ===
-* [http://peir.path.uab.edu/library/index.php?/tags/672-chronic_passive_congestion PEIR Digital Library: Chronic Passive Congestion Images]
+* [{{SERVER}}/library/index.php?/tags/672-chronic_passive_congestion PEIR Digital Library: Chronic Passive Congestion Images]
 * [http://library.med.utah.edu/WebPath/LIVEHTML/LIVERIDX.html#1 Webpath: Hepatic Pathology]

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 * <spoiler text="What is the most common cause of chronic passive congestion of the liver?">Right-sided heart failure. Also, obstruction of the inferior vena cava or hepatic vein (usually associated with neoplasia and/or a hypercoagulable state leading to thrombosis) can cause hepatic congestion</spoiler>
 * <spoiler text="Why is the central vein region most severely affected by chronic passive congestion?">The central vein region is farthest away from the arterial (oxygenated) blood so this region has the lowest oxygen tension anyway. With congestion and stasis, this central vein region becomes hypoxic which results in liver cell atrophy and necrosis. The peripheral regions are hypoxic but and develop fatty change. Thus, the dark red, congested, and necrotic central vein region that is surrounded by yellow fatty change gives the morphology that is termed "nutmeg liver."</spoiler>
 {{IPLab 4}}
 [[Category: IPLab:Lab 4]]

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 == Autopsy Findings ==
-At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface. == Images ==
+At autopsy the lungs were congested and edematous with evidence of lobar pneumonia. The heart weighed 540 grams and showed 75 to 95% atherosclerotic stenosis of all the major coronary arteries. The right and left ventricles were markedly dilated. The ventricular walls were extremely thin with patchy areas of subendocardial fibrosis. The liver weighed 1630 grams and displayed the classic "nutmeg appearance" of chronic passive hepatic congestion on cut surface.
 <gallery heights="250px" widths="250px">
 File:IPLab4ChronicPassiveCongestion1.jpg|This is a gross photograph of a liver demonstrating chronic passive congestion. Note the accentuation of the centrilobular pattern evidenced by the dark-brown-staining areas in this tissue.