A practical approach to the examination of the congenitally malformed heart at autopsy

Area of Science:

• Pathology
• Pediatrics
• Cardiology

Background:

• Congenital heart defects (CHD) are the most common heart disease in childhood, affecting up to 1% of live births.
• Despite advancements in echocardiography, some CHDs remain undiagnosed or lead to pregnancy termination.
• Malformed hearts are frequently encountered during pediatric autopsies.

Purpose of the Study:

• To emphasize the importance of macroscopic heart assessment in pediatric autopsies.
• To highlight the role of pathologists in evaluating structural heart disease.
• To underscore the necessity of understanding basic pathologic anatomy for accurate diagnosis.

Main Methods:

• Review of autopsy findings in pediatric cases with congenital heart defects.
• Comparison of macroscopic examination with echocardiographic diagnostics.
• Emphasis on the pathologist's role in structural heart disease evaluation.

Main Results:

• Macroscopic assessment by pathologists remains the gold standard for evaluating structural heart disease.
• Echocardiography, while improved, may not detect all CHDs.
• Pathologic anatomy knowledge is essential for accurate pediatric autopsy.

Conclusions:

• Pathologists are vital in diagnosing congenital heart defects, complementing imaging techniques.
• Understanding heart pathology is crucial for pediatric autopsies and identifying structural heart disease.
• Despite advanced diagnostics, macroscopic examination by pathologists provides definitive evaluation of heart malformations.