小儿心内膜弹力纤维增生症并室间隔缺损猝死1例

心内膜弹力纤维增生症(endocardial fibroelastosis,EFE)是一种少见的心内膜心肌病,是婴幼儿心脏猝死的常见原因。临床上常突然发病,多因心力衰     

心内膜弹力纤维增生死亡1例

正1案例1.1简要案情某女婴,7个月,某日11:00因咳嗽到某私人诊所就诊,给予对症治疗后好转。当日18:00,出现呼吸困难、口唇发绀等症状,对症治疗后无好转,经抢救无效于当晚死亡。1.2尸体检验尸表检查:女婴,身长68 cm,发育正常,营养一般。口唇黏膜、双手指及双足趾甲床轻度发绀。额部正中、额部右侧及左侧颞顶部各有一注射针眼。躯干及     

心内膜弹力纤维增生症法医学鉴定1例

<正>1案例资料1.1简要案情某女婴,6个月,某月12日因发热到诊所就诊,诊所医生将鱼金注射液、桑姜感冒注射液、地塞米松注射液经肛门注射。13日上午、下午各注射一次同样药物。14日14:00出现呼吸困难、口唇发绀等症状,送正规医院抢救无效死亡。1.2尸体检验尸表检验尸长68cm,发育正常,营养良好。双侧额颞部各有二处注射针孔。余处体表未见损伤。解剖检验心脏肥大(92g);心尖钝圆,心外     

心内膜弹力纤维增生症猝死的分析

1案例资料李某，女，5个月，某日凌晨3时许因出现闭眼，脸色苍白，呼吸不均，气喘，经无证医生治疗，初步检查李某T38．9℃，脉搏不规则，在没有进行皮试的情况下，将头孢唑啉钠、利巴韦林、复方氨林巴比妥注射液各1／3支混合一次臀部肌肉注射，观察半小时后，医生离去。当日凌晨6时许李某出现口唇紫绀，急送医院发现已死亡。     

心内膜弹力纤维增生症死亡1例

1 案例 案情及病史：患儿，男，5个月，某日因哭闹、呕吐并发热（38．6℃）就诊，拟诊胃肠炎，给予静脉输液及口服药物治疗。次日上午出现恶心、呕吐、阵发性哭闹，下午15：20突然全身发绀，双侧瞳孔散大、固定，对光反射消失，经抢救无效死亡。     

心内膜心肌纤维化猝死1例

1．1简要案情 甘某某，男，11岁，小学4年级学生，平素身体健康，不太喜爱运动。2007年3月23日下午1时10分左右，在校园操场跑步时，突然倒在跑道旁的避雷针引线上，不省人事，经抢救无效死亡。     

冠状动脉内弹力膜缺损与冠心病猝死的关系

目的探讨冠状动脉内弹力膜(IEL)病变与冠心病猝死(SCD)的关系。方法从本单位近5年尸检案例中挑选60例病例和心脏标本,分为SCD组、对照组A和B组。每例分别在冠状动脉左前降支近段取材,常规制片,HE和双重组合特殊染色,显微镜下观察冠状动脉IEL,并用图像分析技术对特殊染色的IEL进行形态定量分析。结果60例中,SCD组(男性24例,女性6例,年龄30~83岁)的冠状动脉IEL缺失明显(缺失率=41.64%),未缺失的IEL失去原有弯曲度而变平直;对照组A(冠心病非猝死者,男性13例、女性2例,年龄41~80岁)的冠状动脉IEL缺失程度较SCD组稍轻(缺失率=30.53%);对照组B(无冠心病的其他死者,男性8例,女性7例,年龄17~54岁)的冠状动脉IEL仅有轻度缺失(缺失率=15.67%),多保持原有波浪状结构。统计学分析显示,SCD组与对照组、SCD组与对照组B、对照组A与对照组B之间IEL缺损率的差异均具有极显著性意义;SCD组与对照组A在IEL缺损率上的差异有显著性意义。结论SCD与其冠状动脉IEL缺损率的大小密切相关。     

脑膜瘤猝死1例

1案例资料 某男，48岁，某日凌晨3时许被发现死于一洗浴中心的浴缸内。现场勘查未见特殊。据洗浴中心工作人员反应其洗浴前曾抱怨头昏，并呕吐，呕吐物为少量食物残渣。另据调查，生前于近期曾有说“胡话”、精神恍惚的症状体征，但无头痛，亦未就医，但常去该洗浴中心洗澡以减轻精神压力。     

产褥期肺动脉血栓栓塞猝死医疗纠纷1例

1案例1．1简要案情 某女，24岁，某年1月10日因“足月妊娠”入住某县人民医院，次日阴道分娩一男婴，1月14Et出院。1月21日产妇因“左臀部疼痛5d”再次入住该院。实验室检查：血小板513x10。／L，C反应蛋白46．2mg／L，红细胞沉降率100mrn／h。1月26日患者突然出现意识丧失、口唇苍白、脉搏细速等，经抢救无效死亡。根据尸体解剖、组织病理学检查，并结合相关案情和病历资料认定，死者系产褥期继发双下肢深静脉血栓形成并脱落，引起肺动脉血栓栓塞，导致急性循环、呼吸功能障碍而死亡。家属认为医方的医疗行为存在过错，与患者死亡结果之间存在因果关系。遂诉至法院，要求赔偿。     

限制性心肌病猝死1例

<正> 某男,54岁。既往病史无特殊。某日下午5时许,在棉田劳动时诉身体不适,并坐在田中。因见其身体虚弱,精神不振,嘱其在田边休息,并请医生诊治。医生检查时发现,病者身体虚弱,答非所问,考虑为中暑(当时气温为32℃),让其喝水休息。约6时许,病者起身站立后又倒下,不能走路,被他人扶行约400m后,面色苍白,脉搏微弱,急用车送医院诊治。7时15分到达医院时,生命体征已消失,抢救无效死亡。     

Toxicology and sudden infant death

One hundred thirty cases of sudden infant death occurring in Wayne County, Michigan, (population 2.7 million) were analyzed for possible drugs. The toxicological protocol has been outlined. Six cases were found to be positive, and in five of these the drugs found had been prescribed for a variety of illnesses. In one case methadone was found in the blood of an infant whose mother was undergoing methadone treatment for drug addiction, the drug being transmitted through breast milk. In none of the 102 cases of sudden infant death syndrome (SIDS) included in the study did the toxicological results affect the diagnosis. In our study, toxicological analyses never contradicted an initial diagnosis of SIDS, and, therefore, we feel that this diagnosis should be made promptly based on investigative and autopsy findings.     

A case of sudden infant death due to a primary cardiac sarcoma

The case reported herein concerns the unexpected death of a 3-month-old female newborn who suddenly collapsed in her mother's arms and was dead on arrival at the hospital. The clinical histories of the baby and her parents were negative for symptoms or signs of illness, even those of cardiovascular origin. Furthermore, no clinical appearance of a pathologic status was noted by pediatricians after the birth until the last emergency recovery. The autopsy excluded external and internal signs of violence but revealed a large primary cardiac tumor arising from the free wall of the left ventricle, which had totally invaded the heart causing mitral valve deformation. Histological examination showed a low-grade sarcoma that completely infiltrated the myocardial tissue. The pathogenesis of this sudden infant death was postulated as being owing to a fatal ventricular fibrillation combined with a tumor-related restrictive cardiomyopathy obstructing left ventricular filling.     

Endocardial fibroelastosis as a cause of sudden unexpected death

We present a case of primary endocardial fibroelastosis (EFE) which had been diagnosed in a 16-year-old girl who died suddenly and unexpectedly. This exceptional cause of death in adolescence led to a short literature review comparing our findings with previous medicolegal reports.     

Atypical ventricular septal defect

A case of a congenital cardiac malformation in form of a single ventricular septal defect is reported and histopathologic findings are presented. The possible origin with regard to its untypical localisation is discussed.     

Simultaneous sudden infant death syndrome: a case report.

The first reported case of simultaneous sudden infant death syndrome (SSIDS) in Allegheny County, Pennsylvania, occurred on February 27, 1998. Two-month-old black fraternal twin girls were both found dead in their crib at the same time. After an in-depth death scene investigation, police investigation, toxicologic analysis, and complete autopsies, a specific cause of death could not be identified. The deaths of the two girls were therefore ruled simultaneous sudden infant death syndrome.     

Pathology of sudden infant death syndrome

This study is based on 15 cases examined by the author. The majority of the infants were found in a prone position. Thymus was enlarged in all cases. Its enlargement of the lower portion overlying the basal portion of the heart formed an unyielding, tense membrane. In prone position, the heavy ventricles fell forward, producing angulation and kinking against this membrane and inhibited the filling of the heart or irritated the heart, producing arrhythmia and cardiac arrest.     

Numerous cortical tubers and rhabdomyomas in a case of sudden unexpected infant death

Sudden infant death syndrome is the leading cause of death in infants between the ages of 1 month to 1 year. Sudden infant death syndrome, a diagnosis of exclusion, can only be made after other explanations for unexpected death have been ruled out. Tuberous sclerosis complex is occasionally the findings in these patients with unexpected infant death. Here, we present a case of an unexpected infant death during sleep with multiple factors that confound the cause of death. We discuss these factors and attempt to delineate their contributions to arrive at a cause and mechanism of death.