Context: Cardiovascular diseases are an important cause of morbidity and mortality in both developing and developed countries. The prevalence of coronary artery disease has doubled in Indians during the past three to four decades. Hence, the study was undertaken to evaluate the prevalence of various heart diseases in this region of western Maharashtra.

Aim: The aim was to assess the pattern and prevalence of atherosclerosis involving the coronary arteries and to study the gross and microscopic features of various lesions affecting the valves, myocardium, endocardium and pericardium.

Design: This was a prospective analytical study.

Material and methods: The study included 250 complete heart specimens of medicolegal autopsy cases received from August 2012 to July 2014. Thorough gross examination of atria, ventricles and valves was done followed by examination of the coronary arteries and representative tissue bits were submitted for microscopy.

Results: Atherosclerosis was the most common lesion involving 123 cases with 48 cases of triple vessel disease. Ischemic heart disease was seen in 62 cases, 60 being associated with atherosclerosis. Fourteen cases of left ventricular hypertrophy, nine cases of valvular heart disease, three cases each of cardiomyopathy and disseminated intravascular coagulation, two cases of acute leukemia and one case each of papillary fibroelastoma, amyloidosis, ventricular septal defect and sickle cell anaemia were observed.

Conclusion: Present study emphasizes the role of atherosclerosis in ischemic heart disease. Amyloidosis and rare tumors like papillary fibroelastoma of the heart can be accurately diagnosed on histopathology underscoring the usefullness of an autopsy based study.
Keywords: Atherosclerosis; Ischemic Heart Disease; Valvular Heart Disease.