Sudden cardiac death and acute pathology of coronary arteries
Insights
Sudden cardiac death is often linked to acute coronary arterial lesions. This study found that plaque fissures, hemorrhage, and thrombosis are common in hearts of individuals who died suddenly from cardiac events.
Area of Science:
- Cardiovascular Pathology
- Forensic Pathology
- Cardiology
Background:
- The underlying pathology of sudden cardiac death (SCD) remains debated, especially concerning the condition of coronary arteries.
- Previous research suggests a high incidence of acute coronary lesions in SCD, implying a causal link.
Purpose of the Study:
- To investigate the frequency of acute coronary arterial lesions in patients who experienced sudden cardiac death.
- To determine the types and prevalence of acute lesions in the coronary arteries of SCD victims.
Main Methods:
- Examination of 16 human hearts from individuals who died within 6 hours of myocardial ischemia onset.
- Extensive analysis of the coronary arterial system using post-mortem coronary angiography, decalcification, serial blocking, and histological sectioning.
- Definition of acute coronary arterial lesions included plaque fissure, plaque hemorrhage, and thrombosis.
Main Results:
- Acute coronary arterial lesions were identified in 14 out of 16 hearts (87.5%).
- A total of 28 acute lesions were found, including plaque fissures (9 hearts), plaque hemorrhage (7 hearts), and thrombosis (5 hearts).
- Approximately 50% of acute lesions occurred in atherosclerotic plaques with pre-existing 50-75% luminal narrowing.
Conclusions:
- The study confirms a high prevalence of acute coronary arterial lesions in sudden cardiac death cases.
- Plaque fissures with intramural hemorrhage and intraluminal thrombosis are the most frequent abnormalities observed.
- These acute lesions are strongly implicated as a significant factor in the pathology of sudden cardiac death.
Abstract:
The pathology of sudden cardiac death still is a matter of controversy, particularly with respect to the state of the coronary arteries. A recent study has shown a high incidence of acute lesions and suggests a causal relationship. The present study has been designed to verify whether or not acute coronary arterial lesions occur frequently in patients with sudden cardiac death. Sixteen hearts were available. In each instance the patient had died within 6 hours from the onset of myocardial ischaemia. The coronary arterial system was extensively studied by post-mortem coronary angiography, decalcification, serial blocking and histological sectioning. Acute coronary arterial lesions, defined as plaque fissure, 'isolated' plaque haemorrhage and 'isolated thrombosis', were found in 14 of the 16 hearts (87.5%). The total number of acute lesions in the 14 hearts was 28. In 9 hearts plaque fissures were present, in 7 'isolated' plaque haemorrhages and in 5 an 'isolated thrombus'. Half of all acute lesions had occurred in an atherosclerotic plaque of pre-existing 50-75% luminal narrowing. The present study endorses the concept that acute coronary arterial lesions occur in a high proportion of patients with sudden cardiac death, plaque fissures with intramural haemorrhage and intraluminal thrombosis being the most common abnormality. It is tempting to attribute causal significance to such lesions in patients with sudden cardiac death.
More Related Videos
06:39Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
12:15Tissue Preparation Techniques for Contrast-Enhanced Micro Computed Tomography Imaging of Large Mammalian Cardiac Models with Chronic Disease
Published on: February 8, 2022
Related Concept Videos
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Introduction Cardiac Emergencies