Pathology of the human heart in drowning

Examination of the hearts of ten human drowning victims revealed smooth-muscle contraction banding within the media of the major coronary arteries of eight patients (80%), focal ventricular myocyte hypereosinophilia in eight patients (80%), and ventricular myocyte contraction banding in five patients (50%). These lesions suggest that drowning is associated with a sympathetic storm, which produces both coronary arterial spasm and focal myocyte injury. The lesions may be the first-described positive morphologic markers of drowning in immersed subjects. This study provides further support for the concept that medial smooth-muscle contraction bands may be morphologic markers for antemortem coronary arterial spasm.