HISTOPATHOLOGICAL SPECTRUM OF VARIOUS CHANGES IN HEART – AN AUTOPSY BASED STUDY

Abstract

Introduction: There has been a signicant rise in cardiac-related casualities globally during the last few decades, especially among urban population. In India, ischemic heart disease has become prevalent, affecting roughly 10% of the population. The role of pathologist is to study the various disease process which lead to death and to establish the cause of death. Autopsies are crucial in evaluating the underlying causes responsible for such mortalities. As post-mortem analysis of heart is the the main diagnostic tool to study gross and histopathological changes in healthy or diseased heart, an autopsy study of heart was therefore planned to observe various histopathological changes. Aim and Objectives: The objective of this research was to examine the histomorphological characteristics of different heart lesions, including both gross and microscopic observations, in heart specimens obtained post-mortem at the Department of Pathology, RNT Medical College, Udaipur, over a one-year period. A prospective study was conducted in the Materials and Methods: department of pathology, RNT Medical College Udaipur over a period of one year. We examined a total of 157 autopsies, regardless of the cause of death, with 7 cases being too autolyzed for inclusion. Therefore, our study included 150 whole heart specimens. These specimens underwent gross examination, and microscopic sections stained with H&E were analyzed to identify various histopathological alterations. The observed ndings were then clinically correlated. Atherosclerosis Results: emerged as the predominant cardiac lesion, evident in 67 out of 150 autopsied hearts (44.66%), followed by ischemic heart disease observed in 26 cases (17.33%). Myocardial hypertrophy was present in 21 cases (14%), while myocarditis was noted in 6 cases. Additionally, changes indicative of electrocution were found in 2 cases, tuberculosis in 3 cases, stenosis of the aortic valve in 4 cases, and metastasis from lung carcinoma in 1 case. Age-related alterations were detected in 15 cases, while congestion was observed in 19 cases. Two cases each of rheumatic heart disease and congenital anomalies were also identied. Notably, the cause of death remained undetermined in 47 cases (31.33%) despite comprehensive macroscopic and microscopic examination. Among the major vessels, the left anterior descending artery was the most frequently affected (37.31%), followed by the right coronary artery (32.83%) and the left circumex artery (29.85%). Of the three major vessels, 18.37% exhibited single-vessel involvement, while 34.32% and 47.31% of cases showed involvement of two and three vessels, respectively. Correlation analysis between age and atherosclerosis revealed a signicant p-value of less than <0.05. Although males exhibited a slightly higher prevalence of atherosclerotic changes, the difference was not statistically signicant. Conclusion: Ischemic heart disease emerged as the predominant cause of morbidity and mortality within our society, with atherosclerosis being the prevailing observation. The most frequent pattern of involvement was identied as three-vessel disease