AbstractIntroduction: Acute myocardial infarction is a most common cause of sudden death. Microscopic evidence of infarction is seen in H & E stained section only if person survived for a minimum period of 6 hours after fatal ischemic attack. So for visualisation of infarct of lesser age TTC test can be used. It is a gross staining procedure which can reveal infarct of within 5–6 hrs. age Aim of this study to incorporate this test in study protocol of sudden cardiac death with aim of visualising infarct rather than giving indirect evidence. Objective: To study usefulness of TTC stain as indicator of early myocardial infarction in Autopsy cases. Materials and Methods: The present study was conducted in MGM Medical College Indore on 210 Post-mortem autopsy cases of death due to suspected myocardial infarction. Heart obtained from autopsy cases subjected to gross examination of all three coronary vessels. After cleaning heart, complete transverse slices of ventricular myocardium subjected to TTC macro test. Knife cut slice is dipped in 1% solution of TTC for 20–30 minute. Result: Out of 210 cases brought for post-mortem examination with history of suspected cardiac attack on which TTC stain applied over heart 60 cases were found to show TTC staining reaction. In these cases, it was infracted area show pale to pink and normal areas as bright red. Discussion: Due to the absence of gross and microscopic changes before 6–8 hrs. of post MI survival time, there was a majar hurdle in estabilishing the cause of death by light microscopy in cases of early death due to myocardial infarction. Since biochemical alteration occur following injury to any tissue form pathological changes. After myocardial infarction due to leakage of multiple dehydrogenases enzymes infarcted area did not react with TTC and remain pale and normal myocardial enzyme react with TTC and form Formazone which was bold colour.
Keywords: Sudden cardiac death; Myocardial infarction; TTC Macro test.