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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. == 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 ==
<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.
