Case 1, image 1: This 56-year-old woman died as a result of a deliberate overdose of her prescription medications in combination with alcohol. This fatty infiltration of the right ventricle was an incidental finding.
Case 1, image 2: An unusually high amount of fatty replacement was seen within the wall of the right ventricle.
Fibrofatty replacement of the right ventricle wall with associated inflammation are the histopathologic features of arrhythmogenic right ventricular cardiomyopathy (ARVC). ARVC may be a rare cause of sudden cardiac death usually in young adults. However, variable amounts of intramyocardial fat may be seen in the right ventricle, and this finding may be normal and should not be confused with ARVC.
Burke AP, Farb A, Tashko G, Virmani R. Arrhythmogenic right ventricular cardiomyopathy and fatty replacement of the right ventricular myocardium: are they different diseases? Circulation. 1998 Apr 28;97(16):1571-80.
Tansey DK, Aly Z, Sheppard MN. Fat in the right ventricle of the normal heart. Histopathology. 2005 Jan;46(1):98-104.