Specific Heart Muscle Diseases

Toxic – alcohol, catecholamines, cocaine, Adriamycin

Metabolic – hemochromatosis, hyperthyroidism

Neuromuscular – muscular dystrophy

Storage disease – glycogen, Fabry’s disease

Infiltrative - sarcoidosis

Heart - Becker’s muscular dystrophy – looks like idiopathic dilated cardiomyopathy

Cocaine heart – necrosis with contraction bands. This could happen with any

severe chronic stimulation such as too much pressors in a failing heart or a

pheochromocytoma.

Cardiac Sarcoidosis – well defined granuloma with giant cells. Dosen’t infiltrate &

destroy myocardium like giant cell myocarditis. Eosinophils are less common in sarcoidosis than in giant cell myocarditis.

Hemochromatosis - note the brown perinuclear deposits of hemosiderin. It is,

however, the soluble iron, not the hemosiderin, that is considered toxic.

Hemochromatosis – iron stain (iron is blue

Rheumatic fever – Aschoff body – A collection of cells, often near a vessel, with a

few multinucleate cells and some vesicular nuclei with big nucleoli (Aschoff cells). Anichkov myocytes (not shown) are myocytes with very elongated big nucleoli. This is a marker for rheumatic fever, but the serious damage is to the valves.