Cardiovascular Pathology
Volume 19, Issue 2 , Pages 125-126, March 2010

Blue dye, green heart

Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue/L25, Cleveland, OH 44195, USA

Received 3 April 2008; received in revised form 20 May 2008; accepted 25 June 2008. published online 15 August 2008.

Abstract 

Methylene blue has been used for the rapid reversal of circulatory shock refractory to fluid administration, inotropic agents, and vasoconstrictors. Its clinical side effects have been well described. We report an interesting autopsy observation in patients who received methylene blue as adjunct therapy for septic shock. The exposed surface of cardiac myocardium on both fresh and fixed states rapidly turned green. In the presence of molecular oxygen, the colorless metabolite leukomethylene blue is readily oxidized to methylene blue, thus explaining the visible color change of the myocardium.

Keywords: Methylene blue, Cardiac myocardium

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PII: S1054-8807(08)00072-0

doi:10.1016/j.carpath.2008.06.012

Cardiovascular Pathology
Volume 19, Issue 2 , Pages 125-126, March 2010

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