Sudden death in cardiac myxoma

Nonmalignant tumour (heart myxoma) is often a cause of sudden death. Morphological investigation of 11 heart myxomas (8 in the left atrium, 1 in the right atrium) was performed. These myxomas were generally attached to endocardium in the area of the oval foramen. Sudden death occurred due to infarction of the brain, heart and other vitally important organs as a result of embolism of greater circulation vessels by disintegrated tumour located at the left side of the heart, then due to lung failure caused by embolism of lesser circulation vessels by tumour located at the right half of the heart, and due to heart failure as a result of occlusion of atrioventricular foramen by big myxoma.     

心脏脂肪瘤猝死1例报告

心脏脂肪瘤是一种十分罕见的良性原发性心脏肿瘤.心脏脂肪瘤引起的猝死国内尚未见有报道.我们在法医检案中偶然遇见一例,现报告如下.     

心脏脂肪瘤猝死1例报告

心脏脂肪瘤是一种十分罕见的良性原发性心脏肿瘤。心脏脂肪瘤引起的猝死国内尚未见有报道。我们在法医检案中偶然遇见一例，现报告如下。死者杨某某，男，48岁，生前有心脏病史。因琐事与邻居发生纠纷，吵打中突然倒地，抢救无效死亡。解剖检验：厂长168cm，发育正常，营养中等。睑球结膜苍白，口唇、指甲青紫，口鼻部有多量血性液体流出。全身体表有数处轻微擦挫伤。右肺和胸壁、隔肌轻度粘连、心脏重369g，外形上常。心外膜光滑，心肌暗红色，有光泽，各瓣膜无异常。冠犬动脉畅，轻度粥样硬化。房间隔卵圆窝上部有-60mm×40mm×40mm肿瘤稍…     

Sudden,unexpected death following typhoid-cholera vaccination

A previously healthy 33-year-old Australian male died suddenly and unexpectedly 8 h after a typhoid-cholera vaccination. Such facalities are extreme rarities and the present case is the first in which postmortem measurement of serum immunoglobulins has been undertaken. The clinical course and necropsy findings suggest that death was the result of a slowly evolving systemic anaphylactic reaction which terminated in hypotension and righs heart failure. The deceased was probably atopic. The current recommendations for the vaccination of international travellers against typhoid and cholera are discussed.     

Sudden cardiac death and right ventricular dysplasia.

Right ventricular cardiomyopathy dysplasia, now a well-established clinical and morphologic entity, was first reported in the medical literature in 1982. The cases of sudden death of two young men are here reported, with macroscopic and histologic findings. The anatomical explanation of such death was a fibrotic, lipomatous, or fibrolipomatous replacement and infiltration of the myocardium of the right ventricle. It is suggested that death due to right ventricular cardiomyopathy seems to be the result of electrical instability of right ventricular myocardium. There were no congenital malformations such as septal defect or valvular deformity. The subjects' heart weights were normal. Signs of myocardial degeneration and necrosis with or without inflammatory infiltrates were not identified.     

Sudden death associated with a cardiac diverticulum.

We describe the unusual case of a 20-year-old Aboriginal man who was admitted to hospital with chest pain. He died 1 day later. Necropsy showed extensive anterior myocardial infarction in the left ventricle. An isolated diverticulum arising from the subaortic valve region of the left ventricle had compressed the left main coronary artery.     

Sudden death following administration of radio contrast media

Six patients died suddenly following the administration of radio contrast media. All had received the so-called older agents which are being replaced by newer contrast agents, which are characterized by reduced osmolality. Five of the six patients experienced almost immediate difficulty in breathing followed by death.     

星状神经节麻醉诱发急性心衰猝死1例

案例某男,57岁.主因颈部及左肩部疼痛到某门诊部就治.查体:P80次/分,BP120/80mmHg,颈部活动受限,第6、7颈椎有压痛;左肩关节压痛明显,活动受限.问无心脏病史.     

Sudden death due to an unrecognized cardiac hydatid cyst

Echinococcosis is an endemic disease, most common in sheep-raising communities, usually caused by the larval or cyst stage of the tapeworm Echinococcus granulosus. Isolated cardiac hydatid cyst is uncommon at any age, occurs through the coronary circulation, and accounts for less than 3% of all hydatid disease. We describe a case of an 1%-year-old female, who died suddenly. The post-mortem examination revealed an isolated cyst in the left ventricle of the heart with intact wall. The cytologic examination of the cyst fluid demonstrated the presence of the characteristic scolices and hooklets and established the diagnosis of cardiac hydatid cyst. The present case is of special interest because of the rare primary localization and the onset of sudden death in a young person as the initial manifestation of the disease.     

Sudden cardiac death due to giant cell inflammatory processes

Granulomatous inflammation of the myocardium may occur in a number of systemic disease processes including those with infectious etiologies such as fungal, mycobacterial and parasitic infections, as well as hypersensitivity reactions, and rarely autoimmune disorders. In many of these disorders, giant cells are components of the inflammatory infiltrate. Systemic granulomatous processes of unknown pathogenesis, most notably sarcoidosis, may also be associated with involvement of the myocardium. Occasionally, these disorders are associated with sudden death due to pathologic involvement of the heart. In contrast, giant cell myocarditis, also known as idiopathic myocarditis, a rare, frequently fulminant and fatal disorder of unknown etiology, is isolated to the heart and lacks systemic involvement. This disorder is most commonly diagnosed at autopsy. We present two cases in which sudden death resulted from a giant cell inflammatory process affecting the myocardium. Both individuals lacked antemortem diagnoses and collapsed at their respective places of employment. These cases compare and contrast the clinical and pathologic issues involved in the differential diagnoses of the subgroup of sudden cardiac deaths resulting from giant cell inflammatory processes that affect the myocardium, as well as the value of histologic examination and immunohistochemical studies.     

Sudden death following exercise testing related to abnormalities of the cardiac conduction system and coronary artery pathology

A case of sudden death following exercise testing in a 33-year-old man is reported. The forensic autopsy showed atherosclerotic stenosis of the left coronary artery, as well as some changes in the cardiac conduction system, including anomalies of the atrioventricular node and moderate fibrosis and fatty infiltration of the branching bundle. This case demonstrates that cardiac arrest during vigorous exercise may be multifactorial and that abnormalities of the cardiac conduction system may have played some role in the fatal issue.     

Sudden death resulting from lesions of the cardiac conduction system

Sudden unexpected deaths in young persons with noncontributory histories, autopsy results, and drug screen results are a common problem in forensic pathology. As part of the evaluation of such cases, the cardiac conduction system (CCS) should be studied. To determine the type and incidence of lethal CCS lesions, the authors reviewed their files of sudden unexpected cardiac deaths with particular attention to cases with causes of death in the conduction system. Cases of sudden cardiac death in patients aged < or=40 years during a 10-year period (Michigan) and a 4 year-period (Spain) were selected from the files. From this group, cases were identified in which the cause of death was a lethal change in the CCS. The portions of the heart containing the CCS were excised, and at least one hematoxylin and eosin slide and at least one trichrome or elastic trichrome slide per block were studied. In the two centers, 381 cases of sudden cardiac death were identified. The most common causes of sudden cardiac death were arteriosclerotic narrowing of the coronary arteries, cardiomyopathy, and myocarditis. In 82 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed, a medical history was obtained, and a drug screen was performed. In 11 cases, the CCS contained lesions that were considered lethal: narrowing of the atrioventricular node artery by fibromuscular hyperplasia (7 cases) and atrioventricular node tumors (4 cases). The 11 cases accounted for 2.9% of the 381 cases of sudden cardiac death and 11.8% of the indeterminable cases. It was concluded that examination of the CCS in deaths in which the gross and microscopic autopsy, history, and drug screen fail to provide a cause of death can yield a cause of death in a significant percentage of cases. If heart block was not documented during life and no explanatory lesions were found during routine cardiac examination, examination of the CCS can yield valuable information.     

Sudden death following foreign body entrapment in the esophagus]

Case report about a 53 year old man, suffering from sudden suffocation, caused by inflammatory laryngeal edema following a foreign body traping in the esophagus with consecutive abscess and phlegmona of the esophageal wall.     

监禁中猝死综合征

监禁中猝死综合征是由于高度紧张或躁动状态下,以及其他因素诸如酒精或其他药物的使用、犯人自身的生理情况、特定的强制性体位等因素共同作用下,发生被监禁人员死亡.由于其发生意外,缺乏特征性的尸检结果和毒物分析结果,而成为法医病理学工作者在法医鉴定实践工作中遇到的一个难题.本文总结了相关的危险因素,如犯人的精神状况、药物的使用、被擒拿时所处的体位以及肥胖等,为有效地预防此类事件的发生和法医鉴定工作提供参考.     

Sudden death from asthma

Deaths from asthma investigated by the Department of Forensic Medicine, The Gade Institute, University of Bergen during the period 1977-1986 were recorded. There were 11 cases with information in the police report of the use of pressurised bronchodilating aerosols prior to death. Seven of the victims were found with the aerosol in the hand or close by the body. Overdosage due to excessive inhalation were suspected in several of the victims. The possibility of side effects due to overuse is discussed. Other mechanisms of death are also discussed.