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
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.
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.