Aortic stenosis microscopic pathology


 * Cafer Zorkun, M.D.

Overview
Common findings on microscopic pathologic evaluation in the patient with aortic stenosis include left ventricular hypertrophy and calcific degneration of the aortic valve.

An Autopsy Report
A 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.

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 Imaging 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.