Infective coronary arteritis: a pathological analysis at autopsy.

Area of Science:

• Cardiovascular Pathology
• Infectious Diseases
• Forensic Medicine

Background:

• Coronary artery disease (CAD) is a major global mortality cause, primarily due to atherosclerosis.
• Nonatherosclerotic causes of CAD are rare, with infective arteritis being a recognized but infrequent subtype.
• Infective coronary arteritis, often diagnosed post-mortem, presents a diagnostic challenge.

Observation:

• This study presents clinicopathologic necropsy data from 10 patients who died from infective coronary arteritis.
• The patient cohort included 6 males and 4 females, ranging from a 2-year-old child to adults aged 26-59.
• Associated conditions included infective endocarditis (6 cases), rheumatic heart disease (3 cases), suspected bacteremia/septicemia (2 cases), and pre-existing coronary atherosclerosis (2 cases).

Findings:

• Histopathology revealed acute obliterative inflammatory infiltrate with neutrophils and bacterial colonies in epicardial and intramural coronary arteries.
• This represents the largest reported series of infective coronary arteritis.
• The findings underscore the inflammatory and infectious nature of this rare condition.

Implications:

• Highlights the importance of considering infective causes in nonatherosclerotic coronary artery disease, especially in autopsy findings.
• Suggests potential links between infective endocarditis, bacteremia, and the development of infective coronary arteritis.
• Emphasizes the need for awareness among pathologists and clinicians regarding this rare but fatal condition.