[Ultrastructural analysis of viral and bacterial lesions in human sudden cardiac death]

Sinoatrial node, perinodular working myocardium of the right atrium and subendocardial muscle fibers of the left ventricle of 8 persons who died suddenly at the age of 23-69 years were studied ultrastructurally. In 1% of working cardiomyocytes, in 2 out of 5 cases of sudden cardiac death, viruses were detected. Myofibrils were destroyed in the damaged myocytes but the contact zones with undamaged myocytes remained intact. Rod-like bacteria were observed in the interstitium of the subendocardial myocardium of the left ventricle in one case. Destructive changes of the mitochondria, myofibrils and intercalated discs were found in the myocytes adjacent to bacteria. Viruses and bacteria were absent in 3 control cases. The possible role of viruses and bacteria in the development of sudden cardiac death is discussed.