EVALUATION OF CARDIAC CONDUCTION SYSTEM IN SUDDEN DEATH CASES
Yıl 2013,
Cilt: 27 Sayı: 1, 10 - 15, 30.04.2013
Ramazan Karanfil
Ahmet Hilal
Necmi Çekin
Öz
ABSTRACT
Objective:
In this study, revealing the regional characteristics of the cardiac
conduction system pathologies
in sudden death cases is aimed.
Besides, this is the first study of
Adana region forensic cases related to the cardiac conduction
system pathologies.
Methods:
Twenty seven cases of sudden
unexpected death and 4 cases
with known causes of death as a
control group have been included
in the study. Samples from sinoatrial node and atrioventicular
node were taken in total 31 cases.
Samples were evaluated with light
microscope after staining through
histochemical staining methods.
Results:
There were significant pathological
changes of the sinoatrial node
and atrioventricular node in
10 of the cases. And in 3 of all
cases (11.1%), the abnormalities
of the conduction system were
considered to have the possibility
for causing death.
Conclusion:
We have concluded that it is
of importance to evaluate the
cardiac conduction system in
sudden unexpected death cases
and this topic should be kept in
sight in forensic pathology
Kaynakça
-
Gordon I, Shapiro HA. Forensic Medicine,
2nd Ed., Edinburg, London, Melbourne, New
York: Longman Group Limited, 1982.
-
Cohle SD, Saurez-Mier MP, Aguilera B.
Sudden death resulting from lesions of the
cardiac conduction system. Am J Foren Med
Path 2002;23:83-9.
Denfield SW, Garson A. Sudden death in
children and young adults. Pediatric Clinics
of North America 1990;37(1):215-31.
-
James TN, Kamb ML, Sandberg GA, Silver
RM, Kilbourne EM. Postmortem studies
of the heart in three fatal cases of the
eosinophilia-myalgia syndrome. Ann Intern
Med 1991;115:102-10.
-
Martini B, Nava A, Thiene G, Buja GF,
Canciani B, Scognamiglio R, Daliento L, Volta
SD. Ventricular fibrillation without apparent
heart disease: Description of six cases.
American Heart Journal 1989;118:1203-9.
Sheppard M, Davies JM. Practical
Cardiovascular Pathology. 2nd Ed., New
York: Oxford University Press, 1998.
-
Myerburg RJ, Kessler KM, Castellanos
A. Sudden cardiac death: Epidemiology,
transient risk, and intervention assessment.
Ann Intern Med 1993;119:1187–97.
-
National Institutes of Health. Report of the
Working Group on Arteriosclerosis of the
National Heart, Lung, and Blood Institute
(Volume 2): Patient Oriented Research.
Fundamental and Applied, Sudden Cardiac
Death. Washington, D.C. U.S. Government
Printing Office Publication 1981;82:2035.
-
Basso C, Corrado D, Thiene G. Congenital
coronary artery anomalies as an important
cause of sudden death in the young. Cardiol
Rev 2001;9:312–7.
-
Virmani R, Burke AP, Farb A. Sudden cardiac
death. Cardiovasc Pathol 2001;10:211-8.
-
Hutchins GM. Special studies on the
heart and lung. In, Collins KA, Hutchins GM.
eds. Autopsy performance and reporting.
2nd Ed., Collage of American Pathologists
2003;219-28.
-
Gulino SP. Examination of the cardiac
conduction system - forensic application in
cases of sudden cardiac death. Am J Foren
Med Path 2003;24:227-38.
-
Charlton I, Williams R. Cardiac
conduction tissue, a simplified technique for
examination of the SA and AV nodes. Am J
Foren Med Path 1990;11:213-8.
-
Michaud K, Romain N, Taroni F,
Horisberger B, Mangin P. Evaluation of a
simplified method of the conduction system
analysis in 110 forensic cases. Forensic Sci
Int 2002;130:13-24.
-
Nishida N, Ikeda N, Kudo K, Tsuji A,
Kiyoshima A. Forensic significance of
conduction system abnormalities as a
precise cause of accidental death. Int J
Legal Med 2002;116:344-9.
-
Song Y, Zbu J, Laaksonen H, Saukko
PA. Modified method for examining the
cardiac conduction system. Forensic Sci Int
1997;86:135-8.
-
Goldman L. Ventricular Arrhythmias and
Sudden Death. In, Goldman L, Bennett JC.
eds. Cecil Textbook of Medicine. 21st Ed.,
Philadelphia, Pennsylvania: W. B. Saunders
Company., 2000: 245-8.
-
Gülmen MK, Salaçin S; Tuncer İ.
rhytmogenic right ventricular displasia and
sudden young adult deaths. The Bulletin of
Legal Medicine 1997;2:35-8.
-
James TN. The sinus node. Am J Cardiol
1977;40:965-86.
-
Johnson WD, Strong JP, Oalmann MC,
Newman WP, Tracy RE, Rock WA. Sudden
death from coronary heart disease in young
man. Arch Pathol Lab Med 1981;105:227-32.
-
Lev M. The Conduction System. In,
Gould SE. ed. Pathology of the Heart and
Blood Vessels. 3rd Ed., Springfield, Illinois:
Charles C Thomas-Publisher, 1968:180-209.
-
Malamou-Mitsi V, Pappa L, Vougiouklakis
T, Peschos D, Kazakos N, Grekas G, Sideris
D, Agnantis NJ. Sudden death due to
an unrecognized cardiac hydatid cyst. J
Forensic Sci 2002;47:1062-4.
-
Polson CY, Gee DJ. The Essentials of
Forensic Medicine. 3rd Ed., Oxford, New
York, Toronto, Sydney, Braunschweig.
Pergamon Press, 1973:561-9.
-
Scala-Barnett DM, Donoghue ER.
Sudden death in mitral valve prolapse. J
Forensic Sci 1998;33:84-91.
-
Schwartz CJ, Gerrity RG. Anatomical
pathology of sudden unexpected cardiac
death. Circulation 1975;52:18-26.
-
Song Y, Yao Q, Zhu J, Bin L, Liang S.
Agerelated variation in the intersiticial
tissues of the cardiac conduction system,
and autopsy study of 230 Han Chinese.
Forensic Sci Int 1999;104:133-42.
REFERENCES
-
Song Y, Laaksonen H, Saukko P,
Tiovonen S, Zhu J. Histopathological findings
of cardiac conduction system of 150 Finns.
Forensic Sci Int 2001;119:310–7.
-
Burke AP, Farb A, Virmani R. Causes
of sudden death in athletes. The Athlete’s
Heart 1992;10:303-17.
-
Hilal A. Evaluation of chlamydia
pneumonia antigen in various arteries.
Forensic Medicine Speciality Thesis.
Çukurova University, Adana, Turkey 1998
-
Bakker JMT, Capelle FJL, Janse
MJ, Wilde AAM, Coronel R, Becker AE,
Dingemans KP, Hemel NM, Hauer RNW.
Reentry as a cause of ventricular tachycardia
in patients with chronic ischemic heart
disease: Electrophysiologic and anatomic
correlation. Circulation 1988;77:589-606.
-
Byard RW, Smith NM, Bourne AJ.
Association of right coronary artery hypoplasia
with sudden death in an eleven-year-old
child. J Forensic Sci 1991;36:1234-9.
-
Cohle SD, Lie JT. Pathologic changes
of the cardiac conduction tissue in sudden
unexpected death: A review. Pathology
Annual 1991;26:33-57.
-
Ferris JAJ, Parkin JM. Occlusion of the
atrioventricular nodal artery in congenital
heart block. Beitr Path Bd 1973;149:311-5.
-
Wreford FS, Conradi SE, Cohle SD,
Lie JT, Dana SE, Puri S. Sudden death
caused by coronary artery aneurysms: A
late complication of Kawasaki disease. J
Forensic Sci 1991;36:51-9.
-
Brown DL, Wetli CV, Davis JH.
Sudden unexpected death from primary
pulmonary hypertension. J Forensic Sci
1981;26:381-6.
-
Bromberg BI, Lindsay LD, Cain ME,
Cox JL. Impact of clinical history and
electrophysiologic characterization of
accessory pathways on management
strategies to reduce sudden death among
children with Wolff-Parkinson-White
Syndrome. J Am Coll Cardiol 1996;27:690-
5.
-
Cohle SD, Graham MA, Dowling
G, Pounder DJ. Sudden death and left
ventricular outflow disease. Pathology
Annual 1988;2:97-124.
-
Waller BF, Gering LE, Branyas NA,
Slack JD. Clinical, pathologic correlations
- anatomy, histology and pathology of the
cardiac conduction system – part VI. Clin
Cardiol 1993;16:623-8.
-
Green JR, Korovezt MJ, Shanklin DR,
DeVito JJ, Taylor WJ. Sudden unexpected
death in three generations. Arch Intern Med
1969;124:359-63.
-
Lenegre J. Etiology of bilateral bundle
branch fibrosis in relation to complete heart
block. Prog Cardiovasc Dis 1964;6:317–20.
-
Ridolfi RL, Bulkley BH, Hutchins GM. The
conduction system in cardiac amyloidosis.
Am J Med 1977;62:677-86.
-
Corrado D, Thiene G, Nava A, Rossi
L, Pennelli N. Sudden death in young
competitive athletes: Clinicopathologic
correlations in 22 cases. Am J Med,
1990;89:588-96.
-
James TN, MacLean WAH. Paroxysmal
ventricular arrhythmias and familial sudden
death associated with neural lesions in the
heart. Chest 1980;78:24-30.
-
James TN, Martin ES, Willis PW, Lohr
TO. Apoptosis as a possible cause of gradual
development of complete heart block and
fatal arrhythmias associated with absence
of the AV node, sinus node, and internodal
pathways. Circulation 1996;93:1424-38.
-
Virmani R, Burke AP, Farb A. Sudden
cardiac death. Cardiovascular Pathology
2001;10(5):211-8.
-
Smith ET, Davis GJ. Sudden cardiac death
associated with hypoplasia of the coronary
arteries and conduction system alteration.
Am J Foren Med Path 1997;18:189-93.
Yıl 2013,
Cilt: 27 Sayı: 1, 10 - 15, 30.04.2013
Ramazan Karanfil
Ahmet Hilal
Necmi Çekin
Kaynakça
-
Gordon I, Shapiro HA. Forensic Medicine,
2nd Ed., Edinburg, London, Melbourne, New
York: Longman Group Limited, 1982.
-
Cohle SD, Saurez-Mier MP, Aguilera B.
Sudden death resulting from lesions of the
cardiac conduction system. Am J Foren Med
Path 2002;23:83-9.
Denfield SW, Garson A. Sudden death in
children and young adults. Pediatric Clinics
of North America 1990;37(1):215-31.
-
James TN, Kamb ML, Sandberg GA, Silver
RM, Kilbourne EM. Postmortem studies
of the heart in three fatal cases of the
eosinophilia-myalgia syndrome. Ann Intern
Med 1991;115:102-10.
-
Martini B, Nava A, Thiene G, Buja GF,
Canciani B, Scognamiglio R, Daliento L, Volta
SD. Ventricular fibrillation without apparent
heart disease: Description of six cases.
American Heart Journal 1989;118:1203-9.
Sheppard M, Davies JM. Practical
Cardiovascular Pathology. 2nd Ed., New
York: Oxford University Press, 1998.
-
Myerburg RJ, Kessler KM, Castellanos
A. Sudden cardiac death: Epidemiology,
transient risk, and intervention assessment.
Ann Intern Med 1993;119:1187–97.
-
National Institutes of Health. Report of the
Working Group on Arteriosclerosis of the
National Heart, Lung, and Blood Institute
(Volume 2): Patient Oriented Research.
Fundamental and Applied, Sudden Cardiac
Death. Washington, D.C. U.S. Government
Printing Office Publication 1981;82:2035.
-
Basso C, Corrado D, Thiene G. Congenital
coronary artery anomalies as an important
cause of sudden death in the young. Cardiol
Rev 2001;9:312–7.
-
Virmani R, Burke AP, Farb A. Sudden cardiac
death. Cardiovasc Pathol 2001;10:211-8.
-
Hutchins GM. Special studies on the
heart and lung. In, Collins KA, Hutchins GM.
eds. Autopsy performance and reporting.
2nd Ed., Collage of American Pathologists
2003;219-28.
-
Gulino SP. Examination of the cardiac
conduction system - forensic application in
cases of sudden cardiac death. Am J Foren
Med Path 2003;24:227-38.
-
Charlton I, Williams R. Cardiac
conduction tissue, a simplified technique for
examination of the SA and AV nodes. Am J
Foren Med Path 1990;11:213-8.
-
Michaud K, Romain N, Taroni F,
Horisberger B, Mangin P. Evaluation of a
simplified method of the conduction system
analysis in 110 forensic cases. Forensic Sci
Int 2002;130:13-24.
-
Nishida N, Ikeda N, Kudo K, Tsuji A,
Kiyoshima A. Forensic significance of
conduction system abnormalities as a
precise cause of accidental death. Int J
Legal Med 2002;116:344-9.
-
Song Y, Zbu J, Laaksonen H, Saukko
PA. Modified method for examining the
cardiac conduction system. Forensic Sci Int
1997;86:135-8.
-
Goldman L. Ventricular Arrhythmias and
Sudden Death. In, Goldman L, Bennett JC.
eds. Cecil Textbook of Medicine. 21st Ed.,
Philadelphia, Pennsylvania: W. B. Saunders
Company., 2000: 245-8.
-
Gülmen MK, Salaçin S; Tuncer İ.
rhytmogenic right ventricular displasia and
sudden young adult deaths. The Bulletin of
Legal Medicine 1997;2:35-8.
-
James TN. The sinus node. Am J Cardiol
1977;40:965-86.
-
Johnson WD, Strong JP, Oalmann MC,
Newman WP, Tracy RE, Rock WA. Sudden
death from coronary heart disease in young
man. Arch Pathol Lab Med 1981;105:227-32.
-
Lev M. The Conduction System. In,
Gould SE. ed. Pathology of the Heart and
Blood Vessels. 3rd Ed., Springfield, Illinois:
Charles C Thomas-Publisher, 1968:180-209.
-
Malamou-Mitsi V, Pappa L, Vougiouklakis
T, Peschos D, Kazakos N, Grekas G, Sideris
D, Agnantis NJ. Sudden death due to
an unrecognized cardiac hydatid cyst. J
Forensic Sci 2002;47:1062-4.
-
Polson CY, Gee DJ. The Essentials of
Forensic Medicine. 3rd Ed., Oxford, New
York, Toronto, Sydney, Braunschweig.
Pergamon Press, 1973:561-9.
-
Scala-Barnett DM, Donoghue ER.
Sudden death in mitral valve prolapse. J
Forensic Sci 1998;33:84-91.
-
Schwartz CJ, Gerrity RG. Anatomical
pathology of sudden unexpected cardiac
death. Circulation 1975;52:18-26.
-
Song Y, Yao Q, Zhu J, Bin L, Liang S.
Agerelated variation in the intersiticial
tissues of the cardiac conduction system,
and autopsy study of 230 Han Chinese.
Forensic Sci Int 1999;104:133-42.
REFERENCES
-
Song Y, Laaksonen H, Saukko P,
Tiovonen S, Zhu J. Histopathological findings
of cardiac conduction system of 150 Finns.
Forensic Sci Int 2001;119:310–7.
-
Burke AP, Farb A, Virmani R. Causes
of sudden death in athletes. The Athlete’s
Heart 1992;10:303-17.
-
Hilal A. Evaluation of chlamydia
pneumonia antigen in various arteries.
Forensic Medicine Speciality Thesis.
Çukurova University, Adana, Turkey 1998
-
Bakker JMT, Capelle FJL, Janse
MJ, Wilde AAM, Coronel R, Becker AE,
Dingemans KP, Hemel NM, Hauer RNW.
Reentry as a cause of ventricular tachycardia
in patients with chronic ischemic heart
disease: Electrophysiologic and anatomic
correlation. Circulation 1988;77:589-606.
-
Byard RW, Smith NM, Bourne AJ.
Association of right coronary artery hypoplasia
with sudden death in an eleven-year-old
child. J Forensic Sci 1991;36:1234-9.
-
Cohle SD, Lie JT. Pathologic changes
of the cardiac conduction tissue in sudden
unexpected death: A review. Pathology
Annual 1991;26:33-57.
-
Ferris JAJ, Parkin JM. Occlusion of the
atrioventricular nodal artery in congenital
heart block. Beitr Path Bd 1973;149:311-5.
-
Wreford FS, Conradi SE, Cohle SD,
Lie JT, Dana SE, Puri S. Sudden death
caused by coronary artery aneurysms: A
late complication of Kawasaki disease. J
Forensic Sci 1991;36:51-9.
-
Brown DL, Wetli CV, Davis JH.
Sudden unexpected death from primary
pulmonary hypertension. J Forensic Sci
1981;26:381-6.
-
Bromberg BI, Lindsay LD, Cain ME,
Cox JL. Impact of clinical history and
electrophysiologic characterization of
accessory pathways on management
strategies to reduce sudden death among
children with Wolff-Parkinson-White
Syndrome. J Am Coll Cardiol 1996;27:690-
5.
-
Cohle SD, Graham MA, Dowling
G, Pounder DJ. Sudden death and left
ventricular outflow disease. Pathology
Annual 1988;2:97-124.
-
Waller BF, Gering LE, Branyas NA,
Slack JD. Clinical, pathologic correlations
- anatomy, histology and pathology of the
cardiac conduction system – part VI. Clin
Cardiol 1993;16:623-8.
-
Green JR, Korovezt MJ, Shanklin DR,
DeVito JJ, Taylor WJ. Sudden unexpected
death in three generations. Arch Intern Med
1969;124:359-63.
-
Lenegre J. Etiology of bilateral bundle
branch fibrosis in relation to complete heart
block. Prog Cardiovasc Dis 1964;6:317–20.
-
Ridolfi RL, Bulkley BH, Hutchins GM. The
conduction system in cardiac amyloidosis.
Am J Med 1977;62:677-86.
-
Corrado D, Thiene G, Nava A, Rossi
L, Pennelli N. Sudden death in young
competitive athletes: Clinicopathologic
correlations in 22 cases. Am J Med,
1990;89:588-96.
-
James TN, MacLean WAH. Paroxysmal
ventricular arrhythmias and familial sudden
death associated with neural lesions in the
heart. Chest 1980;78:24-30.
-
James TN, Martin ES, Willis PW, Lohr
TO. Apoptosis as a possible cause of gradual
development of complete heart block and
fatal arrhythmias associated with absence
of the AV node, sinus node, and internodal
pathways. Circulation 1996;93:1424-38.
-
Virmani R, Burke AP, Farb A. Sudden
cardiac death. Cardiovascular Pathology
2001;10(5):211-8.
-
Smith ET, Davis GJ. Sudden cardiac death
associated with hypoplasia of the coronary
arteries and conduction system alteration.
Am J Foren Med Path 1997;18:189-93.