Pathology 6020 - Cardiovascular Pathology - Case 1

Cardiovascular Pathology - Case 1 - Part 4

Part 1

Part 2

Part 3

There were no complications at operation on 9/3/02. At 2 a.m. on the morning of 09/05/2002 she was found apneic. The rhythm on the monitor showed asystole. Full ACL protocol was initiated which included intubation, chest compression, and IV medications. However, she could not be resuscitated. She was pronounced dead at 2:30 a.m. An autopsy was performed.

9-5-02 Laboratory Data
Name	Result/Unit		Ref Interval
WHITE BLOOD CELL COUNT	18.03 K/uL	H	3.20-10.60
RED BLOOD CELL COUNT	1.67 M/uL	L	3.88-5.46
HEMOGLOBIN	5.0 g/dL	LL	12.1-15.6
HEMATOCRIT	15.8 %	LL	34.3-45.2
MEAN CORPUSCULAR VOLUME	94.7 fL	H	77.8-92.5
MEAN CORPUSCULAR HEMOGLOBIN	29.7 pg		26.5-32.6
MEAN CORPUSCULAR HGB CONC	31.4 g/dL	L	32.7-36.9
RED CELL DISTRIBUTION WIDTH	13.0 %		10.8-14.1
PLATELETS	198 K/uL		177-406
MEAN PLATELET VOLUME	7.9 fL		5.9-9.8

Name	Result/Unit		Ref Interval
SODIUM	142 mmol/L		136-144
POTASSIUM	3.5 mmol/L		3.3-5.0
CHLORIDE	115 mmol/L	H	98-107
CARBON DIOXIDE	16 mmol/L	L	22-29
UREA NITROGEN	4 mg/dL	L	7-20
CREATININE, SERUM - mg/dL	0.7 mg/dL		0.7-1.1
GLUCOSE	261 mg/dL	H	64-128
ANION GAP	11 mmol/L		8-14
CALCIUM, SERUM OR PLASMA	7.1 mg/dL	L	8.4-10.2

Name	Result/Unit		Ref Interval
TROPONIN I	0.4 ng/mL		0.0-0.4

Autopsy findings
	Section through the wall of the left ventricle. The heart weighed 509 gms.
	Abdominal aorta opened from the posterior aspect with the head of the patient to the left.
	Sections through the coronary arteries show atherosclerosis what is the percentage of occlusion?

	This artery is distorted because of calcification in the wall.
	Section through the subendocardial region of the left ventricle, what do you see?
	Two sections through the left ventricle, what changes do you see in the myocytes?
	Left Ventricle

1. What do the premortum labs suggest?

2. What was the cause of her sudden death?