| Fibrosis
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Etiology
•Most common cause is coronary arteriosclerosis.
•Other causes: 1. Relative coronary insufficiency due
to cardiac hypertrophy due to hypertension, valvular
disease, or unknown causes. 2. Healed rheumatic
myocarditis. 3. Healed multiple micro-infarcts due to
emboli from vegetations of an infectious endocarditis.
4. Healed infectious, immune, toxic, or idiopathic
myocarditis. 5. Scleroderma.
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Pathogenesis
•Coronary occlusive disease and/or cardiac hypertrophy
result in chronic ischemia with necrosis and fibrosis.
•Repeated attacks of angina pectoris each represent a
micro-infarct, with the evolution of confluent
subendocardial scars.
•Other causes cause myocardial necrosis directly and
heal as scars.,
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Epidemiology
•Varies with different underlying causes.
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General Gross Description
•Scars due to occlusive or relative coronary
insuffuciency are typically subendocardial.
•Scars due to myocarditis of diverse etiologies
are more random.
•Focal Scarring due to scleroderma is uniformly
widespread.
•Examples:
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General Microscopic Description
•The histology of scarring is non-specific, and of no
value to the determination of etiology.
•Scar consists of fibroblasts and collagen
•Examples:
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 523-566.
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| Fibrosis
| | Synopsis by: J. Hasson, MD (T33010M49000)[339]
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