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Subendocardial Hemorrhages
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Subendocardial Hemorrhages

View of outflow tract of left ventricle. The antero- lateral LV wall with the anterior papillary muscle is is retracted to the right above the posterior wall with its papillary muscle.
The exposed endocardial surface below the aortic valve is the left side of the IV septum.
Note the subendocardial hemorrhages (arrows), and the excessively dilated left ventricle.
Causes of hemorrhages include shock, sepsis, clotting deficiencies and thrombocytopenia of any cause.
(Description By:Melinda Sanders,M.D. )
(Image Contrib. by:Melinda Sanders,M.D. UCHC )
Hemorrhage
Etiology

Due to any one or combination of 3 factors: disturbances in coagulation factors, platelet numbers and/or function, or integrity of vessel wall.
Coagulation disorders: hepatic failure, sepsis, shock, disseminated intravascular coagulation (DIC), hereditary deficiencies.
Platelet deficiencies: thrombocytopenia due to neoplastic marrow replacement, autoimmune mechanisms, aplastic anemia, infections, DIC, drugs.
Vessel wall injuries: sepsis, shock, drug reactions with autoimmune vasculitis, DIC, vitamin C deficiency.
Pathogenesis

Any one or combination of the underlying factors, platelet function, coagulation factors, and vessel wall integrity may result in passage of whole blood through vessel wall.,
Epidemiology

Varies with underlying cause.
General Gross Description

Subendocardial petechia and ecchymoses are randomly distributed.
General Microscopic Description

Bland sheets of red blood cells are seen in the interstices.
Inflammatory cells and fibrinoid necrosis of small blood vessels may be seen in cases due immune vasculitis.
Clinical Correlation

Varies with underlying cause.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 616-627.
Hemorrhage
Synopsis by: J. Hasson, MD (T32000M37000)[314]
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