[MEDICAL QUIZ] #4 CARDIOVASCULAR HISTOLOGY

A 69-year-old woman presents with crushing substernal chest pain and nausea. She is treated with plasminogen activator, oxygen, and morphine sulfate. The patient subsequently becomes hypotensive and suffers cardiac arrest. A cross-section of the patient’s anterior interventricular artery is examined at autopsy (shown
in the image). Which of the following best describes the pathologic changes visible in this specimen?

The answer is Atherosclerosis. Atherosclerosis is

the most common acquired abnormality of large- and

medium-sized arteries. Major complications of atherosclerosis, including intermittent claudication, abdominal

aortic aneurysm, coronary artery disease, cerebrovascular disease, and peripheral vascular disease, account for

more than half of the annual deaths in the United States.

Chest pain is the major complaint of patients with coronary artery disease (also referred to as ischemic heart disease). The pain typically occurs in the substernal portion

of the chest and may radiate to the left arm, jaw, and/

or epigastrium. Diabetes mellitus and hyperlipidemia

are risk factors for atherosclerosis. The image shows atherosclerosis in the narrowed lumen. Thrombosis of an

atherosclerotic plaque can result in ischemic necrosis of

the dependent cardiac muscle (myocardial infarction).

Keywords: Atherosclerosis, myocardial infarction