Forensic significance of conduction system abnormalities as a precise cause of accidental death

Nishida, Naoki; Ikeda, Noriaki; Kudo, Kazuhiko; Tsuji, Akiko; Kiyoshima, Akiko

doi:10.1007/s00414-002-0334-7

Cited by 20 publications

(2 citation statements)

References 32 publications

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“…In our case, however, no cardiotonics were used during hospitalization. Moreover, we could not detect any findings which may have induced the arrhythmia, such as a small infarction scar, valvular disorder, hypertropic cardiomyopathy, or any other conductive system abnormalities (Nishida et al, 2002(Nishida et al, , 2003a(Nishida et al, , 2003b. Thus, it was considered that the pointer occurring to ventricular fibrillation was either the posterior wall of the bilateral ventricles or the AV conduction system from the AV node to the His' bundle.…”

Section: Discussionmentioning

confidence: 91%

1. An Autopsy Case of Fatal Arrhythmia Induced by Injuries of the Atrioventricular Conduction System: A case report

et al. 2004

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A 65-year-old woman died three days after being involved in a traffic accident, following an episode of ventricular fibrillation. She was diagnosed as having suffered cardiac contusion, liver contusion, mediastinal hematoma and rib fracture on admission. Her electrocardiogram showed complete right bundle branch block, complete atrioventricular block, and right axis deviation. Aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase and creatine kinase-MB were found to be elevated on biochemical blood analysis. These findings recovered and her condition appeared to improve daily. At autopsy, epicardial and intramyocardial haemorrhage were macroscopically seen in the posterior wall of the bilateral ventricles. On microscopic examination, there was evidence of fresh haemorrhage and coagulative necrosis with inflammatory reaction in the ordinary myocardium and adipose tissue around the atrioventricular node, which had spread to the proximal portion of the His' bundle. It is considered that these findings caused ventricular fibrillation to occur, and that the cause of death in this case was myocardial contusion due to blunt thoracic injury. This case would indicate that myocardium nearby atrioventricular junction is vulnerable to external force. Moreover, it would seem that fatal arrhythmia occasionally occurs during the follow-up stage, despite the lack of any significant clinical findings.

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Section: Discussionmentioning

confidence: 91%

1. An Autopsy Case of Fatal Arrhythmia Induced by Injuries of the Atrioventricular Conduction System: A case report

et al. 2004

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“…On the other hand, microscopic examination of the heart showed severe arteriolosclerosis and diffuse eosinophilic change of the cardiomyocytes, which is considered to be compatible with ischaemic heart disease. Nishida et al (2002) reported that the death of an individual could result from arrhythmia induced by abnormalities of the conduction system in forensic autopsy cases of accidental death. In the current case, stenosis of the lumen in both SA node and AV node arteries and lymphocyte infiltration in the bundle of His were observed in the conduction system, and these may have led to fatal arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Sudden death from ischaemic heart disease in a female patient with Sjögren syndrome

Inoue

Kinoshita²,

Sugiyama³

et al. 2008

Med Sci Law

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Primary Sjögren syndrome (SjS) has a comparatively good prognosis except when it is complicated by non-Hodgkin's lymphoma. We performed an autopsy on a young female patient with primary SjS who had died suddenly during a meal, and we discuss the relationship between primary SjS and the cause of death. Eosinophilic change of the cardiomyocytes and severe arteriolosclerosis were observed within the myocardium. In the conduction system, lymphocyte infiltration was detected in the bundle of His, in addition to arteriosclerosis in the sinoatrial node and atrioventricular node arteries. The cause of death was diagnosed as ischaemic heart disease induced by arteriolosclerosis: its development can probably be attributed mostly to primary SjS. It should thus be kept in mind that primary SjS can occasionally result in the development of cardiovascular complications, such as ischaemic heart disease, as well as systemic lupus erythematosus or rheumatoid arthritis.

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Coronary Sclerosis, Myocardial Infarction, Myocarditis, Cardiomyopathy, Coronary Anomalies, and the Cardiac Conduction System

Dettmeyer¹

2018

Forensic Histopathology

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Forensic significance of conduction system abnormalities as a precise cause of accidental death

Cited by 20 publications

References 32 publications

1. An Autopsy Case of Fatal Arrhythmia Induced by Injuries of the Atrioventricular Conduction System: A case report

1. An Autopsy Case of Fatal Arrhythmia Induced by Injuries of the Atrioventricular Conduction System: A case report

Sudden death from ischaemic heart disease in a female patient with Sjögren syndrome

Coronary Sclerosis, Myocardial Infarction, Myocarditis, Cardiomyopathy, Coronary Anomalies, and the Cardiac Conduction System

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