Post-mortem cardiomegaly descriptor: Call for consistent criteria

Although the post-mortem descriptor of cardiomegaly is an important component of understanding a sudden death, there is no unified definition. A recent survey reported the usage of heart weight correction models of Molina or Kitzman, for example, or simple step cutoffs such as 350, 400, 450, or 500 g in common use. The goal of the present study was to determine how a diagnosis of cardiomegaly relates to these definitions and heart weight using a database of sudden deaths using 1071 autopsy reports from across the USA in which the heart weight and the presence (n = 373) or not (n = 698) of cardiomegaly were recorded. We found that medical examiners appear not to use corrections for body weight but instead rely on step weight cutoffs, predominantly of 350, 400, 450, and 500 g. The decedent's age, weight, ethnicity, and toxicology did not tend to influence a diagnosis of cardiomegaly. The term cardiomegaly is being used with increasing frequency with an average increase of 3.6% per year. Consistency in the post-mortem use of cardiomegaly is lacking.