Sudden death due to a cystic atrio-ventricular node tumour

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine
• Cardiac Electrophysiology

Background:

• Sudden cardiac death (SCD) is a significant public health issue, primarily linked to cardiomyopathies, coronary artery disease, and functional dysregulation.
• Primitive cardiac tumors are an infrequent cause of SCD in adults.
• Pacemaker implantation is a common intervention for cardiac rhythm disturbances.

Observation:

• A case report details an adult male experiencing sudden cardiac death six years post-pacemaker implantation.
• The autopsy revealed an undiagnosed cystic tumor originating in the atrioventricular node.
• The tumor's location and nature were implicated as the cause of the fatal event.

Findings:

• Postmortem histological examination identified a cystic tumor of the atrioventricular node as the cause of death.
• The tumor likely disrupted the cardiac conduction system, leading to fatal arrhythmia.
• This contrasts with more common causes of SCD, emphasizing the rarity of cardiac tumors as a primary cause.

Implications:

• This case underscores the critical need for systematic histological examination of cardiac conduction tissues during forensic autopsies.
• It suggests that even in patients with pacemakers, rare cardiac tumors should be considered in the differential diagnosis of SCD.
• Enhanced diagnostic protocols in forensic pathology may improve the identification of uncommon causes of sudden cardiac death.