An autopsy study of the histopathological spectrum of cardiac diseases in cases of sudden death

Objectives: Sudden death may be due to cardiac or extra-cardiac causes. Sudden cardiac death incidence has been increasing all over the world. This study was planned to observe various histomorphological cardiac changes in patients presenting with sudden death of cardiac etiology. The main objective of this study was to evaluate cardiac findings in forensic autopsy and clinical autopsy pathology cases.
Materials & Methods: This was a descriptive study carried out over a period of 6 months. Total 537 medico-legal and clinical autopsies were performed at our centre out of which sudden death was seen in 289 cases.
Results: This study included 289 cases of sudden cardiac death. Maximum number of cases was in the age-group of 31-40 years and average age was 35.05 years. An overall male preponderance was observed with male to female ratio being 1.83. Grossly, the average weight of heart was 255 gms. Ventricular wall hypertrophy was found in 107(37.02%) cases, left ventricular hypertrophy being more common than right.
Out of 289 cases, 104 cases showed atherosclerosis, 28 cases showed myocarditis with pericarditis. Myocarditis was seen in 20 cases, pericarditis in 16, ischemic heart disease (acute and chronic) in 13 cases, pericardial or myocardial hemorrhage in 6 cases, tuberculosis in 2 cases and vaso-occlusive sickle cell crisis in 1 case.
Conclusion: Ischemic heart disease was the leading cause of death with coronary atherosclerosis as the commonest pathological lesion in adults whereas in children and young adults myocarditis was the common finding.