Pathology cases– cardiac microinfarction in a methamphetamine user

These are sections from the heart of a 35-year-old male who suffered recently diagnosed atrial fibrillation and was found dead at home.   At autopsy, he had lethal levels of methamphetamine and fentanyl.   At autopsy he had pulmonary edema and acute anoxic changes in the brain.  In addition, he had these changes in the heart.


Examination of the left ventricle revealed multiple relatively recent healing microinfarctions:



At higher power, occasional hemosiderin-laden macrophages were present:



Multiple small arteries displayed severe fibromuscular dysplasia:


A brief literature search did not reveal any articles giving a correlation between methamphetamine use and fibromuscular dysplasia, but the association between methamphetamine use and infarction is well established.

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