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Sudden death in infancy due to bicuspid aortic valve
Ferah Karayel1, Abdi Ozaslan, Arzu Akcay Turan
1State Institute of Forensic Medicine, 34246 Istanbul, Turkey. ferahkarayel@mynet.com
Journal of Forensic Sciences
|October 5, 2006
Summary
Congenital bicuspid aortic valve, a rare condition in infants, can cause sudden death. This case highlights a 2-month-old infant whose death was linked to this heart defect and a lung infection.
Area of Science:
- Forensic Pathology
- Pediatric Cardiology
Background:
- Bicuspid aortic valve (BAV) typically presents in adulthood (50-70 years).
- Rarely, BAV can cause sudden unexpected death in infancy and early childhood.
- Congenital heart defects are a significant cause of infant mortality.
Observation:
- Autopsy of a 2-month-old infant revealed a heart weight of 25g.
- Macroscopic examination showed a bicuspid aortic valve (8mm circumference) and thickened ventricular walls.
- Microscopic analysis revealed myocyte hypertrophy, necrosis, and ischemic changes in the heart, along with interstitial pneumonia.
Findings:
- The infant's death was attributed to a congenital bicuspid aortic valve obstructing left ventricular outflow.
- A complicating factor was identified as a lung infection (interstitial pneumonia).
- This case represents a rare instance of BAV causing sudden death in early infancy.
Implications:
- This case underscores the importance of considering congenital bicuspid aortic valve in unexplained infant deaths.
- Forensic pathologists should be aware of the potential for BAV to cause sudden cardiac death in neonates and infants.
- Increased awareness may lead to earlier diagnosis and intervention in at-risk infants, potentially preventing mortality.
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