Hypoplastic coronary artery disease, as a cause of sudden death
Moirangthem Sangita1, Jayanthi Yadav1, Jai Kumar Chaurasia2
1All India Institute Medical Sciences, Bhopal, Forensic Medicine and Toxicology, Bhopal, India.
Insights
Hypoplastic coronary artery disease (HCAD) is a rare condition causing sudden death. This case report details HCAD
Area of Science:
- Cardiovascular Pathology
- Congenital Heart Disease
- Forensic Pathology
Background:
- Hypoplastic coronary artery disease (HCAD) is a rare congenital anomaly affecting coronary arteries.
- It can lead to myocardial infarction and sudden cardiac death.
- Diagnosis is often made post-mortem or via coronary angiography.
Observation:
- A case of sudden death in a 25-year-old female with a history of exertional syncope is presented.
- Autopsy revealed narrowed coronary arteries with thin walls.
- Histopathology showed an underdeveloped and absent muscular layer in specific coronary arteries.
Findings:
- This report details the histopathological findings of structural abnormalities in coronary vessels causing HCAD.
- It highlights the underdeveloped vascular wall, specifically the muscular layer, in affected coronary arteries.
- This is the first reported case describing structural anomalies leading to HCAD.
Implications:
- Understanding the structural basis of HCAD is crucial for early diagnosis and management.
- This case emphasizes the importance of considering rare coronary anomalies in unexplained sudden cardiac death.
- Further research into the etiology and pathogenesis of HCAD is warranted.
Abstract:
Hypoplastic coronary artery disease (HCAD) is a rare coronary artery anomaly that may be the cause of sudden death. It can involve a single or all coronary arteries. This anomaly may cause circulatory insufficiency leading to myocardial infarction. HCAD has no symptoms or may exhibit cardiovascular signs like syncope, dyspnea, chest discomfort, or dizziness. It is often diagnosed at autopsy, and early diagnosis is made with a coronary angiogram. We report HCAD as the cause of the sudden death of a 25-year-old female with a history of loss of consciousness following exertion. On autopsy, all the coronary arteries' lumen was narrowed with thin vessel walls. Histopathological examination shows an underdeveloped and missing muscular layer of the left anterior descending and circumflex coronary arteries' vascular wall. Many cases of HCAD diagnosed by radiographic imaging in living patients have been reported in the literature, but a structural anomaly of coronaries leading to HCAD has not been reported. We report a case of HCAD describing the histopathological examination findings of the vascular wall of coronary vessels illustrating the structural difference.
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