True about subendocardial haemorrhage is all except-
Subendocardial hemorrhages is a striking feature seen in many autopsy cases. It was believed to be an insignificant finding without any particular reference to the cause of death.
However latest reports have indicated that presence of subendocardial hemorrhages is an indicator of exsanguination and head injury
When subendocardial hemorrhages are present on autopsy, the mechanism of death is believed to be exsanguination or head injury
Cardiac lesions secondary to non cardiac injuries are believed to be caused due to massive production of catecholamine due to severe sympathetic stimulation
The hemorrhages in the heart are strictly confined to the subendocardial tissue of the left ventricle. a fact, which distinguishes them on the one hand from hemorrhages seen in anoxia which tend to be subpericardial and subpleural and on the other from the more wide spread hemorrhages some of which may also occur in sub endocardial tissue seen in severe toxemias, septicemias, blood dyscrasias and uremia
Hemorrhages occur in three sites in the left ventricle
Middle third of the interventricular septum is the most common site involved
Base of the papillary muscle is the second most common site of involvement
Posterior wall of the left ventricle is the third most common site of involvement Pathology
The hemorrhages are flame shaped, confluent and tend to occur in one continuous sheet rather than patches.When the bleeding is severe, it may raise the endocardium’s into a flat blister.
May be seen after head injury
Involves RV wall
Continous pattern of sheet
Flame shaped hemorrhages