69 year old man had been hospitalized many times for a longstanding history of ischaemic heart disease with infarction.
The heart (top) shows marked dilatation of the hypertrophied left ventricle. The myocardium is thinned out in more than 50% of the chamber and is replaced by scar tissue with whitish endocardial fibrosis.
The apex of the heart shows communication with a large cardiac aneurysm (outpouching of weakened left ventricle) (bottom). Layers of blackish thrombus material (mural thrombus) are seen lining the thin-walled aneurysm preventing it from rupture.