Postmortem imaging of sudden cardiac death.

Area of Science:

• Forensic pathology
• Cardiovascular imaging
• Radiology

Background:

• Cardiovascular diseases are leading causes of death globally.
• Postmortem imaging complements conventional autopsy but has limitations in cardiovascular pathology.
• Sudden cardiac death (SCD) necessitates accurate postmortem investigation.

Purpose of the Study:

• To review the current state of postmortem imaging for cardiovascular pathologies in SCD cases.
• To discuss the advantages and limitations of various imaging modalities.
• To highlight the need for establishing the role of postmortem radiology in SCD diagnosis.

Main Methods:

• Review of multidetector computed tomography (MDCT), CT angiography, and cardiac magnetic resonance imaging (MRI) in postmortem cardiovascular investigations.
• Evaluation of radiological assessment for ischemic heart disease (IHD) and other SCD causes.
• Consideration of limitations for diagnosing conditions like cardiomyopathies and channelopathies.

Main Results:

• Postmortem CT angiography (PMCTA) effectively detects coronary artery stenoses/occlusions but is less sensitive for ischemic myocardium.
• Cardiac MRI shows potential for myocardial investigation but has limited postmortem accessibility.
• Radiological detection of cardiomyopathies and channelopathies remains challenging.

Conclusions:

• Postmortem imaging offers valuable insights into cardiovascular causes of SCD.
• Further validation is needed for PMCTA and MRI in diagnosing specific cardiovascular pathologies.
• The precise role of postmortem radiology in SCD diagnosis requires further establishment.