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Canine Cardiology Pathology Report Gross description: Examined is the body of a 28.

2 kg, adult, male entire, cross breed dog in very good body condition with moderate subcutaneous and visceral adipose tissue. The right sclera is hyperemic. There is mild but diffuse gingivitis, worse on the right. A diffuse area of hemorrhage is visible in the cranial left mediastinum. There is fixed froth in the trachea and mainstem bronchi which is pink in color. The lungs are wet with a rubbery texture. There is 100.0 ml of both clotted and unclotted blood in the pericardium. The left ventricle is thickened measuring 2.0 cm, as is the right ventricle measuring 1.3 cm. The left atrial appendage is inverted. There are multiple raised ridges and firm nodules palpable and visible through the endothelial surface of the base of the aorta, behind the aortic valve leaflets. There is an extensive horizontal tear just above the coronary sinus, and the aortic media is ripped from the underlying adventitia and folded back on itself, obstructing the lumen. Additional tears and blood dissection through the exposed adventitial plane is also apparent. There is diffuse hemorrhage throughout the pancreas and the stomach is full of undigested food. At the proximal jejunum there is a full thickness, raised nodule measuring 5.0 x 5.0 mm that is red-purple in color. There are multiple areas of full thickness hemorrhage along the length of the jejunum. There is one partial thickness raised nodule measuring 3.0 x 3.0 mm that is red-purple in color in the distal jejunum. There is prostatic hyperplasia. Gross diagnoses: Aorta: Aneurismal dilation and horizontal tear. Pericardium: Hemopericardium. Left atria: Inverted left atrial appendage. Heart: Left and right ventricular hypertrophy. Lungs: Diffuse edema. Pancreas: Diffuse hemorrhage. Jejunum: Multi-focal raised hemorrhagic nodules. Prostate: Hyperplasia. Buccal cavity: Mild, diffuse gingivitis. Histopathology (WNL within normal limits): Slides 1 and 2 Aorta in region of dilation and tear and Aortal distal to the tear: In ruptured areas there are nodular clusters of mineral within the peripheral portions of the tunica media, and there are multifocal areas of medial degeneration and neovascularization. In non-ruptured aorta there are multifocal areas of elastic fiber loss within the media. These tend to be in deeper layers, where smooth muscle cells appear vacuolated and there is widening of the smooth muscle bands with loss of nuclear and cellular detail. The intima is also multifocally expanded in areas distant to the rupture where elastic fibers are mineralized and fragmented and there is subendothelial deposition of amorphous, acellular pale eosinophilic material. Hemorrhage is evident in the surrounding adventitia and adipose. Lung: There is diffuse interstitial congestion and there are multifocal areas of intra-alveolar hemorrhage. Slides 3-4 Liver: There is marked vascular congestion. Spleen: There is red pulp contraction. Thyroid gland: WNL. Adrenal gland: WNL. Kidney: There is diffuse vascular congestion. Slide 5 Intestine: There are hematomas multifocally present around omental arteries. Pancreas: There is extensive interlobular hemorrhage. Slides 6-7 Brain: WNL. Final diagnoses:
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Aorta: Aneurismal dilation; severe, multifocal medial necrosis and mineralization; multifocal subintimal degeneration; horizontal rupture with adventitial dissection. Pericardium: Hemopericardium. Left atria: Inverted left atrial appendage. Heart: Left and right ventricular hypertrophy. Lungs: Diffuse edema. Pancreas: Diffuse hemorrhage. Jejunum: Multi-focal hemorrhage. Prostate: Hyperplasia. Buccal cavity: Mild, diffuse gingivitis. Comment: The cause of death is presumed cardiac tamponade, likely complicated by occlusion of the aortic lumen and inversion of the left atrial appendage at or immediately following rupture. The underlying pathology within the aorta was profound and appears to have been progressing for some time, with numerous deposits of mineral present within the wall of the vessel. The lesion appears to have been due to a focal anatomical defect as no other arteries in this dog had similar changes. Gross Photos:

Cranial mediastinal hemorrhage.

Blood clot within pericardial sac and inverted left auricular appendage.

The next two images are pre and post fixation showing the linear tear in the base of the aorta and back folding of the stripped tunica media.