ABC | Volume 110, Nº4, April 2018

Anatomopathological Correlation Nunes et al. A 73 year-old man with ischemic heart disease and cachexia Arq Bras Cardiol. 2018; 110(4):388-392 Figure 3 – Histological sections of epicardial coronary arteries. Calcified atherosclerosis with luminal obstruction greater than 50% in the major branches. In the first centimeter of the right coronary artery (RC1), there is diffuse intimal fibrosis, with no lipid. In the first centimeter of the posterior interventricular branch of the right coronary artery (PD1) and of the circumflex branch (CX1), there are atherosclerotic plaques with fatty center and cholesterol crystals (arrows), surrounded by fibrosis (F). In the fourth centimeter of the anterior interventricular branch (AD4), there is luminal occlusion by an old recanalized thrombus, with multiple lumina and small vessels formed in the repairing process (*). Hematoxylin-eosin, 25x (RC1, CX1 and AD4) and 50x (PD1). Figure 4 – Chronic passive congestion. Lungs: thickening and tortuosity of the veins (A) and muscularization and hypertrophy of the media layer of an intra-acinar arteriole (B). Liver: sinusoidal dilatation in centrilobular areas (C). Spleen: intense congestion and widening of the red pulp; small, non-reactive lymphoid follicles (*). Hematoxylin‑eosin, 100x (A and D) and 400x (B). Masson trichrome, 50x (C). in the left ventricular anterior wall with an organizing thrombus in the endocardium subjacent to the healed infarction area; 5) congestive heart failure; 6) aspiration pneumonia; 7) mixed hemodynamic shock (cardiogenic/infectious). (Léa Maria Macruz Ferreira Demarchi, MD) Comments Ischemic heart disease (IHD) is the major cause of death in Brazil and worldwide, with higher incidence in men aged 40 years and older. 8,9 Coronary atherosclerosis is the major contributor to the occurrence of IHD, despite the global 391