Obstructive coronary ostial thromboemboli mimicking vegetation

Area of Science:

• Cardiology
• Forensic Pathology
• Pediatrics

Background:

• Sudden cardiac death (SCD) in adolescents is uncommon, often linked to undiagnosed cardiac issues.
• Intracardiac or vascular thromboembolism can mimic vegetations, complicating postmortem diagnosis.
• Comprehensive investigation, including histopathology, is vital for determining cause of death.

Purpose of the Study:

• To report a case of sudden cardiac death in an adolescent.
• To highlight the diagnostic challenge of coronary thromboembolism mimicking vegetations.
• To emphasize the importance of detailed autopsy in unexplained adolescent SCD.

Main Methods:

• Case report of a 14-year-old female with sudden cardiac death.
• Autopsy including gross examination and histopathological analysis.
• Differential diagnosis of vegetation-like masses in coronary ostia.

Main Results:

• Autopsy revealed vegetation-like masses obstructing coronary ostia in a 14-year-old girl.
• No evidence of infection or typical thromboembolism risk factors found.
• Coronary thromboembolism was suspected, potentially exacerbated by dehydration during Ramadan fasting.

Conclusions:

• Coronary thromboembolism can present as vegetation-like masses, mimicking other cardiac pathologies.
• Histopathological examination is crucial for accurate diagnosis in such cases.
• Thorough medicolegal autopsies are essential for understanding SCD in adolescents, especially without known risk factors.