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How a person died. If there were a thrombus, what would that look like . If we find a thrombus, if the person dies quickly, we wont see anything in the heart muscle. People need to survive for hours from their acute cardiac event before we can see changes in their heart. Again, if a person dies very quickly from a coronary event, we can only infer what happened based on the fact that they have bad coronaries and the circumstances of their death. We wouldnt expect the heart muscle to look abnormal. If the heart muscle shows damage from a clot, what does that look like . That depends on how long the clot has been there and how long the person survived. Theres a generally good progression of changes we see very, very early. All you might see under the microscope is some of the heart cells look wavy and abnormal. They take on way more pigment after that. They look much brighter under the microscope. As the heart cells start to die, that necrosis brings in an inflammatory reaction from the ....