Sudden unexpected death with dysplastic change in the atrioventricular node artery

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine
• Cardiac Electrophysiology

Background:

• Sudden cardiac death (SCD) in young individuals is a critical concern.
• Alcohol consumption is a known risk factor for cardiovascular events.
• Atrioventricular (AV) node artery abnormalities can predispose to arrhythmias.

Purpose of the Study:

• To investigate the cause of sudden death in a 19-year-old male.
• To identify potential cardiac pathologies contributing to fatal arrhythmia.
• To explore the role of AV node artery morphology in sudden cardiac events.

Main Methods:

• Autopsy examination of a 19-year-old male who died suddenly during sleep after alcohol consumption.
• Macroscopic and microscopic analysis of cardiac structures, focusing on the left ventricle and conduction system.
• Histopathological evaluation of the epicardial atrioventricular (AV) node artery and surrounding ventricular septum.

Main Results:

• The heart showed concentric left ventricular hypertrophy without other significant abnormalities.
• Microscopic examination revealed stenosis and intimal thickening of the AV node artery.
• Acute ischemic changes were identified in the ventricular septum beneath the conduction system.

Conclusions:

• The findings suggest a localized ischemic event within the ventricular septum as the proximate cause of death.
• Fatal arrhythmia, likely due to dysplastic changes in the AV node artery, is considered the cause of death.
• This case highlights the potential for coronary artery anomalies to precipitate lethal arrhythmias in young adults.