ABC | Volume 113, Nº4, October 2019

Anatomopathological Correlation Martins et al. Cardiac failure after non-ST-elevation myocardial infarction Arq Bras Cardiol. 2019; 113(4):775-782 Figure 5 – Cross section of the heart in the middle portion of the ventricles, showing grayish-white areas that correspond to end-stage infarcts in all left ventricular walls. The coronary arteries had atherosclerosis, moderate in the anterior interventricular (anterior descending) and circumflex branches of the left coronary artery (66%maximal obstructions in the first centimeter and 59% in the third centimeter, respectively) and specifically severe in the right coronary artery (77% obstruction in the fourth centimeter). There was no thrombosis or other occlusive lesions (Figure 7). As the patient had cardiogenic shock, there was a small occipital cerebral infarction with a few days of evolution. No cavitary lesion or thrombus occluding the left ventricular apex was evidenced. Figure 6 – Histological section of the left ventricular myocardium showing the boundary between preserved (more rosy, left) myocardium and healing necrosis area. Hematoxylin and eosin coloring; lens magnification: 10x. 1 Lung sections did not show recent bronchopneumonia. An important finding was pancreatic lipomatosis, with almost complete replacement of exocrine pancreatic tissue by fat, leaving only the islets (Figure 8). Dr. Paulo Sampaio Gutierrez) Anatomopathological diagnoses: Ischemic heart disease, with myocardial infarction in the final stage of healing in all left ventricular walls. Pancreatic lipomatosis. Dr. Paulo Sampaio Gutierrez) “Causa mortis”: cardiogenic shock (Dr. Paulo Sampaio Gutierrez) 780