Myocardial infarct, subendocardial, gross
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This heart was from a patient with congenital aortic stenosis. Left ventricular hypertrophy ensued, because of increased pressure needed to push blood out of the stenotic valve. Eventually, the severe stenosis compromised coronary artery circulation in the Sinus of Valsalva, and in combination with LV hypertrophy, a circumferential sub-endocardial myocardial infarct occurred. This resulted in pump failure and fatal cardiogenic shock.