IPLab:Lab 2:Hypertrophy: Difference between revisions - Pathology Education Instructional Resource

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== Clinical Summary ==

This 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.

This 68-year-old man came to the hospital with complaints of exercise intolerance and occasional peripheral edema. He gave a history of a "heart murmur" that was diagnosed 20 years ago during an employment physical but no follow up care had been given for this murmur. On examination the patient had peripheral edema and shortness of breath and a 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.

~~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 disclosed a markedly enlarged heart weighing 650 grams. 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.

~~== Autopsy 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~~.

== Images ==

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File:IPLab2Hypertrophy6.jpg|This gross photograph shows an example of normal physiologic hypertrophy. The organs shown are an open uterus (1), cervix (2) and vagina (3), both ovaries (4) and both kidneys (5) from a woman who died shortly after normal delivery from causes unrelated to childbirth. Note the marked thickening of the uterine wall due to smooth muscle cell hypertrophy.

</gallery>

== Virtual Microscopy ==

=== Myocardial Hypertrophy ===

<peir-vm>IPLab2Hypertrophy</peir-vm>

=== Normal Heart ===

<peir-vm>IPLab2Hypertrophy_normal_Heart</peir-vm>

== Study Questions ==

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=== Images ===

* [~~http://peir.dnsdynamic.com~~/library/index.php?/tags/76-cardiomyopathy PEIR Digital Library: Cardiomyopathy Images]

* [{{SERVER}}/library/index.php?/tags/76-cardiomyopathy PEIR Digital Library: Cardiomyopathy Images]

* [~~http://peir.dnsdynamic.com~~/library/index.php?/tags/1202-hypertrophy_biventricular PEIR Digital Library: Cardiac Hypertrophy Images]

* [{{SERVER}}/library/index.php?/tags/1202-hypertrophy_biventricular PEIR Digital Library: Cardiac Hypertrophy Images]

* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#11 WebPath: Cardiomyopathies]

== Related IPLab Cases ==

* [[IPLab:Lab 6:Scleroderma|Lab 6: Lung: Scleroderma]]

[[Category:IPLab:Lab 2]]

@@ Line 1: / Line 1: @@
 == Clinical Summary ==
-This 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.
+This 68-year-old man came to the hospital with complaints of exercise intolerance and occasional peripheral edema. He gave a history of a "heart murmur" that was diagnosed 20 years ago during an employment physical but no follow up care had been given for this murmur.  On examination the patient had peripheral edema and shortness of breath and a 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.
-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 disclosed a markedly enlarged heart weighing 650 grams. 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.
-== Autopsy 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.
 == Images ==
@@ Line 16: / Line 13: @@
 File:IPLab2Hypertrophy6.jpg|This gross photograph shows an example of normal physiologic hypertrophy. The organs shown are an open uterus (1), cervix (2) and vagina (3), both ovaries (4) and both kidneys (5) from a woman who died shortly after normal delivery from causes unrelated to childbirth. Note the marked thickening of the uterine wall due to smooth muscle cell hypertrophy.
 </gallery>
+== Virtual Microscopy ==
+=== Myocardial Hypertrophy ===
+<peir-vm>IPLab2Hypertrophy</peir-vm>
+=== Normal Heart ===
+<peir-vm>IPLab2Hypertrophy_normal_Heart</peir-vm>
 == Study Questions ==
@@ Line 38: / Line 42: @@
 === Images ===
-* [http://peir.dnsdynamic.com/library/index.php?/tags/76-cardiomyopathy PEIR Digital Library: Cardiomyopathy Images]
+* [{{SERVER}}/library/index.php?/tags/76-cardiomyopathy PEIR Digital Library: Cardiomyopathy Images]
-* [http://peir.dnsdynamic.com/library/index.php?/tags/1202-hypertrophy_biventricular PEIR Digital Library: Cardiac Hypertrophy Images]
+* [{{SERVER}}/library/index.php?/tags/1202-hypertrophy_biventricular PEIR Digital Library: Cardiac Hypertrophy Images]
 * [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#11 WebPath: Cardiomyopathies]
+== Related IPLab Cases ==
+* [[IPLab:Lab 6:Scleroderma|Lab 6: Lung: Scleroderma]]
 {{Template:IPLab 2}}
+[[Category:IPLab:Lab 2]]