case_images: PMC5228664_01
case_images: (A) A bruise was found between the right inferior vena cava and the right coronary sulcus of the posterior atrioventricular groove epicardium. (B) Hemorrhage was present on the leading edge of the coronary sinus from the perspective of right atrium (as the red arrow show). (C) The horizontal section showed the transmural hemorrhage that involved the coronary sinus (the red arrows indicate). (D) The laceration was seen on the lower edge of the coronary sinus (the black arrow indicate).
case_images: medi-96-e5688-g001.jpg
case_images: PMC5228664_01_medi-96-e5688-g001.jpg
case_images: F1
case_images: The heart was enlarged and dilated (weight 466 g) with an area of recent bruising measuring 2.0 cm x 1.5 cm between the right inferior vena cava and the right coronary sulcus of the posterior atrioventricular groove epicardium (Fig. 1A). From the perspective of the right atrium (RA), hemorrhage was present on the leading edge of the coronary sinus (Fig. 1B). Dissection of the right atrial wall showed the transmural hemorrhage that involved the coronary sinus (Fig. 1C). In addition to the foregoing lesions, a laceration was seen on the lower edge of the coronary sinus (Fig. 1D).
case_images: PMC5228664_02
case_images: (A) Hemorrhage was seen between the left coronary leaflet and right coronary of the atrioventricular node (AVN) region (the red arrow). Hemorrhage was clear within the AVN via hematoxylin-eosin staining (B: HE stain, x100). Hemorrhage was obvious within the AVN via Masson trichrome staining (C: Masson trichrome stain, x100).
case_images: medi-96-e5688-g002.jpg
case_images: PMC5228664_02_medi-96-e5688-g002.jpg
case_images: F2
case_images: The heart weighed 215 g, which was within the normal reference range, and hemorrhage measuring 0.6 cm x 0.2 cm was present between the left coronary leaflet and right coronary of the AVN region (Fig. 2A). Histological examination showed interstitial foci of hemorrhage, preferentially located around the AVN with broken myocardial fibers (Fig. 2B and C).
case_images: PMC5228664_03
case_images: (A) Hemorrhage was found between the fossa ovalis and the coronary sinus orifice of the AVN region (the white arrow). Myocardial cells were divided into different shapes by the red blood cells (B: HE stain, x100).
case_images: medi-96-e5688-g003.jpg
case_images: PMC5228664_03_medi-96-e5688-g003.jpg
case_images: F3
case_images: Hemorrhage measuring 1.7 cm x 1.2 cm was found in the AVN region of the facies diaphragmatica cordis, preferentially located near the fossa ovalis and the coronary sinus orifice (Fig. 3A). Myocardial cells with cytoplasmic swelling and vacuolar degeneration were divided into different shapes by the red blood cells (Fig. 3B).