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The modern management of acute myocardial infarction has been associated with substantial changes in the pattern of disease which pathologists encounter in the post mortem room. The role of the pathologist is no longer restricted to the mere confirmation of the clinical diagnosis, which in the majority of cases was beyond reasonable doubt. In many centres this lack of doubt has been one reason for the falling rate of post mortem examinations in patients admitted to coronary care units. There are, of course, very few pathologists who specialise specifically in cardiovascular diseases and the largest number of these are based in centres in which heart and lung transplantation are performed. Nevertheless all pathologists who undertake autopsy examinations must have a sound …