Myocardial fibrosis

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Author: Mikael Häggström [notes 1]

Presentations

Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).

Microscopic evaluation

In case of myocardial fibrosis, attempt to distinguish between the following:

  • Interstitial fibrosis, which is unspecific,[1] (and may simply reported as such).[notes 2]
  • Subepicardial fibrosis, also unspecific (and may simply be reported as such).[notes 3]
  • Replacement fibrosis, which indicates an older infarction.[1]

Reporting

Example (if uncertain whether there is replacement fibrosis or merely subepicardial fibrosis):

Histopathology of dense fibrous scar replacing myocyte loss in myocardial infarction.jpg
Fibrosis of mainly replacement-type which may indicate an older infarction.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. Interstitial fibrosis has been described in congestive heart failure, hypertension, and normal aging. (Chute, 2019)
  3. Subepicardial fibrosis is associated with non-infarction diagnoses such as myocarditis and non-ischemic cardiomyopathy.
    - Gräni, Christoph; Eichhorn, Christian; Bière, Loïc; Kaneko, Kyoichi; Murthy, Venkatesh L.; Agarwal, Vikram; Aghayev, Ayaz; Steigner, Michael; et al. (2019). "Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis ". Journal of Cardiovascular Magnetic Resonance 21 (1). doi:10.1186/s12968-019-0520-0. ISSN 1532-429X. 
    - Bhaskaran, Ashwin; Tung, Roderick; Stevenson, William G.; Kumar, Saurabh (2019). "Catheter Ablation of VT in Non-Ischaemic Cardiomyopathies: Endocardial, Epicardial and Intramural Approaches ". Heart, Lung and Circulation 28 (1): 84–101. doi:10.1016/j.hlc.2018.10.007. ISSN 14439506. 

Main page

References

  1. 1.0 1.1 Chute, Michael; Aujla, Preetinder; Jana, Sayantan; Kassiri, Zamaneh (2019). "The Non-Fibrillar Side of Fibrosis: Contribution of the Basement Membrane, Proteoglycans, and Glycoproteins to Myocardial Fibrosis ". Journal of Cardiovascular Development and Disease 6 (4): 35. doi:10.3390/jcdd6040035. ISSN 2308-3425.