Background: Cardiovascular disease is a leading cause of death in men and women worldwide. Atherosclerosisis the most important cause of cardiovascular disease. Based on the severity, atherosclerosis can be graded histopathologycally from Type I to Type VI. Cardiac autopsy is the main diagnostic tool to study various histopathological changes in autopsy heart specimens. 

Objectives: To study the histopathological spectrum and determine the occurrence of atherosclerosis in coronary arteries in autopsy heart specimens.

Materials and Methods: This is a retrospective record based study on autopsy heart specimens received at the department of pathology from January 2020 to December 2021. Gross and histopathological fndings were recorded from autopsy register. The histopathological spectrum of atherosclerosis and its occurrence were studied and analyzed.

Results: A total of 141 heart specimens were considered for the study out of which 131 cases (92.9%) showed coronary atherosclerosis ranging from Type I to Type VI lesions. Age of the deceased ranged from one month to ninety two years. One hundred four cases (79.38%) were males and twenty seven cases (20.62%) were females. Fifty four cases (41.2%) belonged to the age group of 41-60 years. Type III–VI lesions were considered signifcant. 70.87% of right coronary arteries, 76.8% of left circumflex arteries and 76.9% of left anterior descending arteries showed signifcant atherosclerosis. Left anterior descending artery was found to be the most commonly involved by atherosclerosis (79.4%).

Conclusion: Examination of coronary arteries in autopsy heart specimens plays an important role in determining the cause of cardiovascular diseases and gives an idea about the frequency at which atherosclerosis is encountered among the general population.