Post-mortem cardiomegaly descriptor: Call for consistent criteria.

Area of Science:

• Forensic Pathology
• Cardiovascular Pathology

Background:

• Cardiomegaly is a key post-mortem finding in sudden death cases.
• Current definitions of post-mortem cardiomegaly lack standardization, with varied approaches including heart weight correction models and simple weight cutoffs.

Purpose of the Study:

• To investigate the relationship between diagnosed cardiomegaly and various definitions of heart weight.
• To analyze the consistency of cardiomegaly diagnosis in sudden death autopsy reports.

Main Methods:

• Analysis of 1071 autopsy reports from sudden death cases across the USA.
• Examination of recorded heart weights and cardiomegaly presence/absence.
• Comparison of diagnoses against common weight cutoffs (350-500g) and correction models.

Main Results:

• Medical examiners predominantly use simple weight cutoffs (350-500g) rather than body weight correction models.
• Decedent's age, weight, ethnicity, and toxicology did not significantly influence the cardiomegaly diagnosis.
• The frequency of cardiomegaly diagnosis has increased by an average of 3.6% annually.

Conclusions:

• There is a lack of consistency in the post-mortem diagnosis of cardiomegaly.
• The reliance on arbitrary weight cutoffs contributes to diagnostic variability.
• Standardized definitions are needed for accurate interpretation of heart weight in forensic pathology.