== Clinical Summary ==
This 83-year-old male developed chest pain. He had been awakened the previous night with dull chest pain which was retrosternal and radiated through to his back. The pain was associated with sweating, nausea, and vomiting and could not be relieved by antacids. He refused to go to the doctor but the next morning he developed severe epigastric pain and had several episodes of tachycardia (150-160 beats per minute) and later cardiac standstill. He had a history of hypertension and diabetes.
This 83-year-old white male was admitted with At autopsy the chief complaint of chest painheart weighed 500 grams. He had been awakened There was massive acute myocardial infarction (about 2 days old) involving the previous night with dull chest pain which was retrosternal posterior left ventricle, interventricular septum, and radiated through right ventricle from apex to his backbase. The pain infarct was associated with sweating, nauseatransmural, and vomiting and could not be relieved by antacids. Nitroglycerin gave prompt relief. Following admission he developed cardiac arrhythmias. His AST there was found to be 130 IU/La small rupture in the soft infarcted area at the apex. In the early morning There were 1200 mL of blood within the day after admissionright pleural cavity, he developed probably secondary to this rupture. The coronary arteries showed moderate to severe epigastric pain and several episodes of tachycardia (150-160 beats per minute) and later cardiac standstill. He expired less than a day after admission. There was a history of hypertension and diabetesatherosclerosis throughout the coronary tree.
== Autopsy Findings ==