Dissection #1, Dissection #2, Recanalization, Pinpoint stenosis (2023), Pentachrome

The coronary arteries are three small vessels that supply blood and oxygen to the heart muscle itself. As they are critical to life, forensic pathologists take a special interest in the three main coronary arteries (the left anterior descending, the right, and the left circumflex) and their branches.

Coronary artery stenosis is better known as “heart disease” and refers to the buildup of fats and cholesterols on the inner surface of the vessels, partially or completely blocking blood flow to the heart. The vessels also sometimes undergo calcification with age, better known as “hardening of the arteries”.
Full or partial cross-sections of the arteries show the narrowing and calcification of vessels. Coronary artery dissections occur when a small tear of the inner surface of the vessels allows blood to accumulate in the space between the layers of the artery wall, sometimes compressing the main channel and preventing blood from reaching the heart muscle itself. Dissections are caused by stress on the wall of the coronary artery and can be associated with drug use, pregnancy, and trauma.

Recanalization of a coronary artery occurs when small channels form to bridge a blocked area