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[Subendocardial hemorrhage from the forensic medicine viewpoint]
W Keil1, T Rothämel, H D Tröger
1Institut für Rechtsmedizin, Medizinischen Hochschule Hannover.
Beitrage Zur Gerichtlichen Medizin
|January 1, 1991
Summary
Microscopic examination reveals that most "subendocardial hemorrhages" found during autopsies are not true hemorrhages. This suggests reconsidering the diagnostic term for these common cardiac findings.
Area of Science:
- Forensic Pathology
- Cardiovascular Pathology
- Histopathology
Context:
- Routine autopsy casework frequently encounters macroscopic findings described as 'subendocardial hemorrhages'.
- These macroscopic observations often lack clear microscopic correlates, leading to diagnostic uncertainty.
- The reliability of 'subendocardial hemorrhage' as a pathological diagnosis is questioned due to observed discrepancies.
Purpose:
- To investigate the histological accuracy of macroscopically identified 'subendocardial hemorrhages'.
- To compare macroscopic and microscopic findings in 175 cardial tissue samples.
- To determine the prevalence of true hemorrhage versus other microscopic findings in these samples.
Summary:
- Histological examination of 175 cardial tissue samples revealed that only 8.6% of macroscopically identified 'subendocardial hemorrhages' were true hemorrhages.
- A significant proportion, 53.7%, showed only hyperemia, while 37.7% had no microscopic findings.
- No correlation was found between histological findings and cardial localization, cause of death, or resuscitative actions.
Impact:
- The study highlights significant discrepancies between macroscopic and microscopic findings in autopsy cases.
- It suggests a potential loss of hemoglobin from erythrocytes as a cause for these discrepancies.
- The findings necessitate a re-evaluation of the term 'subendocardial hemorrhage' in forensic and cardiovascular pathology.