CASE HISTORY

The patient was a woman aged 67 who was admitted with 3 weeks history of malaise, one week’s diarrhoea and severe chest pain for 12 hours. She was thought to have myocardial infarction and later cardiomyopathy was suggested. She was shocked and fibrillating but improved on intravenous hydrocortisone and frusemide but relapsed into cardiogenic shock, left ventricular failure, oliguria and finally died 4 days after admission.

PATHOLOGY

The specimen shows a pale thrombus with all the features of ante- mortem origin. It is noteworthy that although it occludes the lumen it is not being organised, although its colour indicates that it is not recent. This probably means occlusion was not complete and some marginal recanalisation of the blood was possible. The renal arteries are not involved.