IPLab:Lab 4:Chronic Passive Congestion

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Clinical Summary[edit]

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.


Virtual Microscopy[edit]

Liver Chronic Passive Congestion[edit]

Normal Liver[edit]

Study Questions[edit]

Additional Resources[edit]


Journal Articles[edit]


Related IPLab Cases[edit]

Myocardial infarction is necrosis of myocardial tissue which occurs as a result of a deprivation of blood supply, and thus oxygen, to the heart tissue. Blockage of blood supply to the myocardium is caused by occlusion of a coronary artery.

Renal failure is the severe reduction of renal function and often leads to reduced urinary output.

Cardiac index is a measure of a patient's cardiac output in relation to body size.

In alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents.

A normal heart weighs 300 grams (range: 270 to 360 grams).

A normal liver weighs 1650 grams (range: 1500 to 1800 grams).

Chronic passive hepatic congestion is a disorder seen in conjunction with right-sided heart failure. In right-sided heart failure, peripheral venous pressures increase and thus reduce outflow from the liver. The result is a chronically congested liver.