Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-14T04:59:29.600Z Has data issue: false hasContentIssue false

Chapter 2 - Examination of the Heart

Published online by Cambridge University Press:  19 August 2019

Michael T. Ashworth
Michael T. Ashworth
Affiliation:
Great Ormond Street Hospital for Children, London
Get access

Summary

Methods of dissection of the heart are described and illustrated. Simulated echocardiographic views are described and illustrated, and advice is given on how best to obtain them and in what circumstances they are most useful. Sequential segmental analysis is described in the context of the normal and malformed heart. Sampling for histology is described for the post-mortem heart and for cardiac specimens submitted to the surgical pathologist. A short guide to photography is given. The tables provide a summary of histological features of the normal heart and their significance and also summarise the application of immunohistochemistry to the heart.

Keywords

Dissectionsequential segmental analysisechocardiographic viewshistologyphotography
Type
Chapter
Information
Pathology of Heart Disease in the Fetus, Infant and Child
Autopsy, Surgical and Molecular Pathology
 , pp. 33 - 52
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hutchinson, JC, Arthurs, OJ, Ashworth, MT et al. Clinical utility of post-mortem microcomputed tomography of the fetal heart: diagnostic imaging vs macroscopic dissection. Ultrasound Obstet Gynecol 2016; 47: 58–64.CrossRefGoogle Scholar
Anderson, RH, Ho, SY. Sequential segmental analysis – description and categorization for the millennium. Cardiol Young 1997; 7: 98–116.CrossRefGoogle Scholar
Van Praagh, R, David, I, Gordon, D, Wright, GB, Van Praagh, S. Ventricular diagnosis and designation. In Godlman, M (ed.) Pediatric Cardiology, Vol 4. Edinburgh: Churchill Livingstone; 1981, pp. 153–168.Google Scholar
Basso, C, Burke, M, Fornes, P et al.; Association for European Cardiovascular Pathology. Guidelines for autopsy investigation of sudden cardiac death. Virchows Arch 2008; 452: 11–18.CrossRefGoogle ScholarPubMed
Donnelly, WH, Hawkins, H. Optimal examination of the normally formed perinatal heart. Hum Pathol 1987; 18: 55–60.Google Scholar
Stone, JR, Basso, C, Baandrup, UT et al. Recommendations for processing cardiovascular surgical pathology specimens: a consensus statement from the Standards and Definitions Committee of the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology. Cardiovasc Pathol 2012; 21: 2–16.CrossRefGoogle Scholar
Cunningham, KS, Veinot, JP, Butany, J. An approach to endomyocardial biopsy interpretation. J Clin Pathol 2006; 59: 121–129.CrossRefGoogle ScholarPubMed
Collins, AB, Smith, RN, Stone, JR. Classification of amyloid deposits in diagnostic cardiac specimens by immunofluorescence. Cardiovasc Pathol 2009; 18: 205–216.Google Scholar
Toor, AA, Ramdane, BA, Joseph, J et al. Cardiac nonamyloidotic immunoglobulin deposition disease. Mod Pathol 2006; 19: 233–237.CrossRefGoogle ScholarPubMed
Leone, O, Veinot, JP, Angelini, A et al. 2011 consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology. Cardiovasc Pathol 2012; 21: 245–274.CrossRefGoogle Scholar
Tan, CD, Baldwin, WM, Rodriguez, ER. Update on cardiac transplantation pathology. Arch Pathol Lab Med 2007; 131: 1169–1191.Google Scholar
Stewart, S, Winters, GL, Fishbein, MC, et al. Revision of the 1990 working formulation for the standardization of nomenclature in the diagnosis of heart rejection. J Heart Lung Transplant 2005; 24: 1710–1720.Google Scholar
Berry, GJ, Burke, MM, Andersen, C et al. The 2103 International Society of Heart and Lung Transplantation Working Formulation for the standardization of nomenclature in the pathologic diagnosis of antibody-mediated rejection in heart transplantation. J Heart Lung Transplant 2013; 32: 1147–1162.CrossRefGoogle Scholar
Lamke, GT, Allen, RD, Edwards, WD, Tazelaar, HD, Danielson, GK. Surgical pathology of subaortic septal myectomy associated with hypertrophic cardiomyopathy. A study of 204 cases (1996–2000). Cardiovasc Pathol 2003; 12: 149–158.CrossRefGoogle ScholarPubMed
Allen, RD, Edwards, WD, Tazelaar, HD, Danielson, GK. Surgical pathology of subaortic septal myectomy not associated with hypertrophic cardiomyopathy: a study of 98 cases (1996–2000). Cardiovasc Pathol 2003; 12: 207–215.CrossRefGoogle Scholar
Cazes, A, Van Huyen, JPD, Fornes, P et al. Mechanical ventricular assistance in heart failure: pathology of the cardiac apex removed during device implantation. Cardiovasc Pathol 2010; 19: 112–116.CrossRefGoogle ScholarPubMed
Jain, D, Dietz, HC, Oswald, GL, Maleszewski, JJ, Halushka, MK. Causes and histopathology of ascending aortic disease in children and young adults. Cardiovasc Pathol 2011; 20: 15–25.Google Scholar
Nordmeyer, S, Murin, P, Schulz, A et al. Results of aortic valve repair using decellularized bovine pericardium in congenital surgery. Eur J Cardiothorac Surg 2018; 54: 986–992.CrossRefGoogle ScholarPubMed
Kapadia, MR, Popowich, DA, Kibbe, MR. Modified prosthetic vascular conduits. Circulation 2008; 17: 1873–1882.Google Scholar
Liepinsh, E, Kuka, J, Dambrova, M. Troubleshooting digital macro photography for image acquisition and the analysis of biological samples. J Pharmacol Toxicol Methods 2013; 67: 98–106.CrossRefGoogle ScholarPubMed
Rampy, BA, Glassy, EF. Pathology gross photography: the beginning of digital pathology. Clin Lab Med 2016; 36: 67–87.Google Scholar
Pawlak, A, Gil, RJ, Kulawik, T et al. Type of desmin expression in cardiomyocytes – a good marker of heart failure development in idiopathic dilated cardiomyopathy. J Intern Med 2012; 272: 287–297.Google Scholar
Suurmeijer, AJ, Clément, S, Francesconi, A et al. Alpha-actin isoform distribution in normal and failing human heart: a morphological, morphometric, and biochemical study. J Pathol 2003; 199: 387–397.CrossRefGoogle Scholar
Orlandi, A, Hao, H, Ferlosio, A et al. Alpha actin isoforms expression in human and rat adult cardiac conduction system. Differentiation 2009; 77: 360–368.CrossRefGoogle ScholarPubMed
Weeks, DA, Chase, DR, Malott, RL et al. HMB-45 staining in angiomyolipoma, cardiac rhabdomoma, other mesenchymal processes, and tuberous sclerosis-associated brain lesions. Int J Surg Pathol 1994; 1: 191–198.Google Scholar
Terracciano, LM, Mhawech, P, Suess, K et al. Calretinin as a marker for cardiac myxoma. Diagnostic and histogenetic considerations. Am J Clin Pathol 2000; 114: 754–759.Google Scholar
Asimaki, A, Tandri, H, Huang, H et al. A new diagnostic test for arrhythmogenic right ventricular cardiomyopathy. N Eng J Med 2009; 360: 1075–1084.Google Scholar
Ordway, GA, Garry, DJ. Myoglobin: an essential hemoprotein in striated muscle. J Exp Biol 2004; 207: 3441–3446.CrossRefGoogle ScholarPubMed
Noutsias, M, Seeberg, B, Schultheiss, HP, Kühl, U. Expression of cell adhesion molecules in dilated cardiomyopathy: evidence for endothelial activation in inflammatory cardiomyopathy. Circulation 1999; 99: 2124–2131.CrossRefGoogle ScholarPubMed
Severs, NJ, Bruce, AF, Dupont, E, Rothery, S. Remodelling of gap junctions and connexin expression in diseased myocardium. Cardiovasc Res 2008; 80: 9–19.Google Scholar
Husain, AN, Mirza, KM, Fedson, SE. Routine C4d immunohistochemistry in cardiac allografts: long-term outcomes. J Heart Lung Transplant 2017; 36: 1329–1335.Google Scholar
Nagao, K, Sowa, N, Inoue, K et al. Myocardial expression level of neural cell adhesion molecule correlates with reduced left ventricular function in human cardiomyopathy. Circ Heart Fail 2014; 7: 351–358.Google Scholar
Burke, AP, Mont, E, Kolodgie, F et al. Thrombotic thrombocytopenic purpura causing rapid unexpected death: value of CD61 immunohistochemical staining in diagnosis. Cardiovasc Pathol 2005; 14: 150–155.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×