histology of heart disease

Some Histological Some Histological Appearances of Heart Appearances of Heart

DiseaseDiseaseA macroscopic and microscopic view of

some examples of heart diseasesDr Brian Mitchelson

Qatar Cardiovascular Research Centre

The human heart - normal

Thick muscular walls to pump blood around the whole body

Small volume of blood

Left ventricle


Seriously not normal-not normal- dilated cardio-myopathy

Very thin muscle walls

Large volume, with thin muscle walls the heart struggles to pump this volume of blood around the body

Left ventricle


An H&E stained slide of normal heart muscle

Normal bundles of heart muscle fibres


This slide is stained to show areas of fibrosis following any damage to the heart muscle

Areas of fibrosis show up as bright red fibres


A slide from the abnormal heart

This shows pale bands of fibrosis in the diseased heart following an infarction (Heart Attack)


A higher powered view

Heart muscle fibres

Pale areas of fibrosis


Specially stained to show the fibrosis

The bright red fibres are the fibrosed areas of heart muscle


A High magnification of the fibrosis

Heart muscle

FIBROSIS


The problems caused by Fibrosis

The fibres replace the working heart muscles, so the already thin wall of the heart has even less ability to contract and pump blood around the body.The fibres are relatively rigid compared to the contractile heart muscles preventing the muscles from contracting fully.


Coronary ArteriesCoronary Arteries

The problems caused by high cholesterol

diets.


A good arteryA good artery

Thin black elastic fibres lining the inside of the artery


A reasonably good Coronary Artery

The artery walls are not significantly thickened and the lumen of the vessel is not significantly blocked


The same artery stained to show elastic fibres in the wall of the

artery

Black elastic fibres

The start of a cholesterol build-up


A very poor coronary artery

Artery outer wall

Original inner wall

Blood space

Blockage caused by hard calcified cholesterol


The same artery stained to show the outline of the original artery wall

The original inner wall


The loss of elastic fibres in the artery

Barely visible black elastic fibres of the original inner lining


A loss of elastic fibres in some areas of the artery

Loss of the black elastic fibres


Some other abnormalities

The following slides show some of the other abnormalities and

diseases which we can find in the heart


An antibody used to help indicate rejection in a heart transplant

The brown staining antibody can normally be seen, in small amounts, in the tiny vessels of the heart muscle

This transplanted heart does not show signs of rejection


Severe rejection

This biopsy shows severe rejection problems where almost all the vessels show heavy antibody staining


A very rare genetic disease

The bright red stained fibres are heart muscle cells now filled with a neutral fat

NEUTRAL LIPID STORAGE DISEASE

Heart ValvesHeart Valves

Heart valves prevent the blood from flowing back into the chambers of the heartThe valves are subject to wear and tear over the years and either become floppy or calcified and then fail to work effectivelyBad teeth, bleeding gum disease or recreational drug use can severely damage these valves.


Normal and Abnormal Valves


A fairly normal valveA fairly normal valve

A badly infected A badly infected valve segmentvalve segment

Normal and Abnormal Valves


This valve is fairly normalThis valve is fairly normal

Infected areaInfected area

An ABNORMAL VALVEAn ABNORMAL VALVE

The possible effects of poor The possible effects of poor teeth or injecting heroin etcteeth or injecting heroin etc


Necrotic DEAD tissueNecrotic DEAD tissue

Colonies of BacteriaColonies of Bacteria

Viral Myocarditis


Necrotic dead heart muscleNecrotic dead heart muscle

Heart muscle fibresHeart muscle fibres

Amyloid DiseaseAmyloid Disease

This disease is a result of chronic long-term illness such as Rheumatoid arthritis, but may also occur spontaneously.Amyloid is an abnormal protein which forms in the tissues: sometimes called wear and tear protein.This protein can form deposits in the heart muscle and causes problems for the muscle contraction.


A slide showing a heart muscle biopsy stained to show the presence of Amyloid


Heart muscle fibres

Blue staining amyloid protein invading the heart muscle

A Higher powered view of the displacement of the heart muscle

by amyloid


THE ENDTHE ENDThank you for your attention.

If you have any questions please ask

Dr Brian Mitchelson.

histology of heart disease

Health & Medicine

loss of elastic fibres

byfibrosisthe fibres

showelastic fibres

heart muscleareas of

abnormal protein

muscle wallslarge volume

severerejection problems

abnormal heartthis