De Subitaneis Mortibus

James, Thomas N.; Marshall, Mary L.; Craig, M. W. Millar

doi:10.1161/01.cir.50.2.395

Cited by 16 publications

(2 citation statements)

References 11 publications

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“…We surmise that the AV node artery in our case was chronically or transiently pressed by the circumferential architecture due to a chronic increase in intracardiac pressure, which may have been caused by degeneration of the cardiac myocytes and/or pulmonary hypertension due to AP abuse. Stenosis of the AV node artery is sometimes the cause of sudden cardiac death (James et al, 1974;Nishida et al, 2000). Accordingly, severe emotional stress experienced while being arrested could produce an increasing pressure load on the heart (Melville and Raftery, 1981;Giannuzzi et al, 1991), and severe fatal mechanical stenosis of the AV node artery could occur subsequently.…”

Section: Discussionmentioning

confidence: 99%

Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities

et al. 2003

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A 51-year-old man suddenly collapsed while being arrested. He was an abuser of methamphetamine (MP) with a history of previous convictions. The blood MP concentration at autopsy was below the lethal level. The heart revealed hypertrophy and endocardial thickening of the bilateral ventricles. On microscopic examination, the typical findings of hypertrophic cardiomyopathy were not seen, however endocardial thickening with increasing elastic fibres was seen in all the ventricles and in the atria. In the conduction system, the AV node artery with luminal narrowing was longitudinally compressed by circumferential tissue. Severe interstitial fibrosis and small scar formation of the superiorventricular septum were also seen. In addition, diffuse hypertensive pulmonary arteriopathy was seen in the lung parenchyma. We surmise that the AV node artery had been chronically compressed by the circumferential architecture, due to a chronic increase in intracardiac pressure. We believe that the pathological lesions noted in both the cardiac conduction system and the lung in our case may be a complication of MP abuse, and that an MP abuser with such lesions could easily die suddenly upon experiencing emotional stress.

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Section: Discussionmentioning

confidence: 99%

Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities

et al. 2003

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“…None had fibrosis of the AVN or His bundle. The authors found 13 other cases of sudden death due to FMH of the AVN artery (17)(18)(19)(20)(21). One patient has a history of third degree AV block and syncope, six had fibrosis of the AVN, His bundle or both and one had an infarct of the His bundle.…”

Section: Fmh Of the Avn Arterymentioning

confidence: 99%

Histopathology of the Cardiac Conduction System in the Investigation of Sudden Unexpected Death

Cohle

2011

Academic Forensic Pathology

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When a gross and microscopic autopsy, drug screen, and past medical history fail to yield a cause of death, the forensic pathologist may opt to study the cardiac conduction system. This paper describes the excision of the SA (sinoatrial) node and AV(atrioventricular) node-containing areas of the heart and the microscopic appearance of normal SA and AV nodes, His bundle and bundle branches. Conduction system findings that have been reported to be significant include fibromuscular hyperplasia (often mislabeled dysplasia) of the SA and AV nodes arteries, persistent fetal dispersion of the AV node and His bundle, accessory pathways, ganglionitis and neuritis near the SA node, fibrosis and fatty infiltration of the conducting tissue, AV node tumor, left-sided His bundle, and AV node fibrosis. In an otherwise normal autopsy, AV node tumors, severe fibromuscular hyperplasia of the AV node artery and AV node fibrosis are sufficient to cause death. Other findings, particularly Mahaim tracks, are competent causes of death if they correlate with premortem electrocardiographic findings. Conduction system examination, although a low-yield procedure, is a worthwhile endeavor. Care must be taken to not overestimate the significance of the findings.

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Anatomy and Pathology of Small Coronary Arteries

James¹

1987

Coronary Circulation

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De Subitaneis Mortibus

Cited by 16 publications

References 11 publications

Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities

Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities

Histopathology of the Cardiac Conduction System in the Investigation of Sudden Unexpected Death

Anatomy and Pathology of Small Coronary Arteries

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