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Biopsy Findings in Coronary Arteries of Sudden Cardiac Death

Vennila Vijayasree* , Vennila Vijayasree* , W. Sandhya Manohar** , Sunethri Padma***

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Indian Journal of Forensic Medicine and Pathology 9(1):p 21-27, Jan-Mar 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijfmp.0974.3383.9116.4

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Abstract

 Background: Coronary artery disease (CAD) is a leading cause of death of women and men worldwide. Approximately17.5 million people per year die due to this cause, representing 30% of all deaths in the world; of these, 7.6 million were caused by coronary heart disease. Aims and Objectives: To demonstrate the histopathological changes in the coronary arteries of the dead bodies of the sudden cardiac death. Study Design: It’s a cross sectional Retrospective study. Materials and methods: We performed an autopsy analysis (n=16, 5women, 11 men of SCD which occurred in patients aged over 50 years during 2011 to 2014. The following variables were considered: sex, age, medical history, autopsy findings to macroscopic and histological evaluation of the heart. The autopsies were performed according to standard techniques. In all subjects, the heart was dissected following standard autopsy protocol and a 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery, but including the region of origin of the circumflex branch and left coronary artery (LCA) from its origin till the circumflex branch were excised, dissected out, fixed in 10% formalin, marked for identification and sent for histopathological analysis. Observation and Discussion:  Atherosclerotic plaques were identified in 6.5% of specimens, 69% of males and 31% of female. Such plaques were typically concentric and more represented with necrosis, calcification, cholesterol crystals, and giant cells, as well as had a higher inflammatory cell count. Furthermore, intima and media thickness of coronary arteries were significantly higher in studied specimens with visualize the connective tissue layers of the adventitia and the fatty acid containing adipose cells in the periadventitial tissue. Conclusion: In this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict  SCD. Altogether, an enhanced understanding of the pathobiologic processes responsible for atherosclerotic changes might allow for early identification of a high-risk coronary plaque and there by provide a rationale for innovative diagnostic and/or therapeutic strategies for the management of coronary patients and prevention of acute coronary syndromes. 

Keywords: Caronary artery disease(CAD); Sudden cardiac death; Atherosclerosis.

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DOI: DOI: http://dx.doi.org/10.21088/ijfmp.0974.3383.9116.4

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