Answers:

CASE 10 A

1. Findings:

a. eosinophilic material within alveolar spaces indicating pulmonary edema with acute left heart failure (Figure 1A)

b. hemosiderin laden macrophages within alveolar spaces indicating chronic left heart failure (Figure 1B)

2. Clinical symptoms:

a. Shortness of breath, frothy pink sputum, pleural effusions, cardiomegaly.

3. Possible etiologies for the above diagnosis:

a. Most common cause of left heart failure is myocardial ischemia. Other causes include hypertension, valvular heart disease and primary myocardial diseases.

CASE 10 B

A 70 year old female presented with increasing shortness of breath. She had a longstanding history of mitral stenosis.

Questions:

1. Findings:

a. Congested “nutmeg” liver; dilated and congested sinusoids

2. Findings:

a. Mitral stenosis leads to right heart failure and systemic venous congestion

b. Spleen congestion

3. Other causes:

a. right sided heart failure secondary to left heart failure is the most common

b. Interstitial lung diseases, emphysema, congenital heart disease.

4. Atrial fibrillation

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