Published in:
01-09-2015 | Images in Forensics
Histological appearance of anomalous anterior papillary muscle
Published in: Forensic Science, Medicine and Pathology | Issue 3/2015
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A 36-year-old man was found dead after a high voltage accident. At the autopsy, although the heart weight was normal (320 g), there was a slightly asymmetric thickening of the septum (maximum thickness 18 mm), compared to the lateral wall of the left ventricle (maximum thickness 16 mm), with narrowing of the left ventricle space. However, as an incidental finding, examination of the heart also revealed an anomaly; the left anterior papillary muscle was inserted directly into the ventricular surface of the anterior mitral leaflet throughout a thick fibrous stripe, 2–3 mm in diameter, impregnated with muscle fibers. Chordae tendineae were absent in the area of the direct anomalous muscle insertion (Fig. 1).
Fig. 1
Macroscopic appearance of aberrant insertion of the enlarged left anterior papillary muscle into the ventricular surface of the anterior mitral leaflet, on fresh (a) and formalin fixed (b) sample (Case 1, 36-year-old man). The thick fibrous stripe on the cephalad portion of the muscle is impregnated with muscle fibers, while chordae tendineae are absent. Note the point of insertion of this stripe into the ventricular surface of the anterior mitral leaflet (**), with visible muscle fibers on the lower part of the leaflet
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