Left heart failure--increased pulmonary venous pressure--pulmonary congestion

Right heart failure--increased pressure in the systemic venous system--congestion of the liver, spleen, kidneys, etc.

Venous compression (external pressure): tumors, pregnant uterus, intussusception, liver cirrhosis

Venous cavity obstruction (internal resistance): thrombosis, emboli (when metabolism cannot be performed)

Naked eyes: large (congested tissues or organs are swollen in size), purple (congested tissues and organs are dark red in color, and reduced hemoglobin is increased), cool (local blood stagnation, capillary dilation, and increased heat dissipation)

Microscopically: dilated veins and capillaries, increased red blood cells. When the capillary cavity is large and congestion is obvious, it is often accompanied by edema and even bleeding.

Cause: Left heart failure, venous return obstruction and pulmonary congestion

General appearance: The lungs are swollen, the weight is increased, the texture is solid, the color is dark red, and there is light red foamy liquid flowing out from the extruded section.

Under the microscope: the capillaries in the alveolar septa are dilated and congested more obviously. In addition to edema fluid and hemorrhage in the alveolar cavities, a large number of macrophages containing hemosiderin particles, called heart failure cells, are also seen, and the alveolar walls are thickened and fibrotic.

Outcome: Long-term chronic pulmonary congestion leads to lung tissue ischemia and hypoxia, leading to lung tissue fibroplasia and finally brown sclerosis of the lungs.

Cause: Right heart failure, obstruction of hepatic venous return and hepatic congestion

General: In chronic liver congestion, the central area of ​​the liver lobules turns dark red due to severe congestion, while the liver cells in the periphery of the liver lobules turn yellow due to fatty degeneration, resulting in red (congestion area) and yellow (hepatic fatty degeneration) appearing on the cut surface of the liver. Area) Alternating stripes that resemble the cut surface of betel nut are called betel nut liver

Microscopically: congestion in the central area of ​​the lobule, fatty degeneration of liver cells in the peripheral area, and in severe cases, hemorrhage of central cells, atrophy and fibrosis of necrotic cells

Outcome: early stage: the disease is reversible; late stage: liver interstitial fibrous tissue hyperplasia---congestive cirrhosis

Site: Heart valve, artery or vein thrombosis head

Naked eye: Vegetation - off-white, solid, tightly adherent to underlying tissue

Under the microscope: mainly composed of platelets and a small amount of fibrin, called platelet thrombus

Site: Tail component of venous thrombosis

Naked eyes: dark red, fresh, smooth, moist, and elastic; old, dry, inelastic, brittle, and easy to fall off

Under the microscope: The fibrin network is filled with evenly gathered red blood cells like normal blood.

Location: venous thrombosis body, intracardiac cavity, aneurysm

Naked eye: Gray white and brown stripes, rough, dry.

Under the microscope: light red irregular platelet trabeculae, intertrabecular fibrin network and red blood cells, neutrophils can be seen at the edge of platelet trabeculae

Mixed thrombi that occur within the cardiac chambers, atherosclerotic ulcers, or aneurysms are called mural thrombus

Location: Occurs in the blood vessels of microcirculation (mainly capillaries)

Naked eye: Invisible - micro-thrombus (microscopic thrombus)

Under the microscope: Mainly composed of cellulose - fibrinous thrombus, common in DIC (disseminated intravascular coagulation)

Gross: Occurs in organs with relatively dense tissue structure and less collateral circulation, such as kidneys, heart, spleen, etc. In the early stage, there are dark red congestion and hemorrhage bands around them, which later turn to yellowish brown and scar formation.

Microscopically: coagulative necrosis, tissue outline remains, and granulation tissue and scar formation may occur in the late stage.

Conditions for occurrence: severe congestion, increased intravenous pressure accompanied by arterial obstruction, dual blood supply, loose tissue

Commonly found in lungs and intestines

It is caused by the obstruction of emboli containing putrefactive bacteria, which is common in infective endocarditis. The emboli containing bacteria fall off from the endocardium, causing blood vessel embolism in corresponding tissues and organs.