Kalpte Yaygın Fibrozis Bulunan 12 Yaşında Anı Kardiyak Ölüm Olgusu

Abstract

…ZETOlgumuz 12 yaßõnda, oyun oynarken fenalaßõp hastaneye šlŸ duhul eden erkek •ocuÛudur. Dõß muayenede sol meme baßõ i• yanda iÛne pikŸr izi ve gšÛŸs šnde defibrilatšr kaßõk izleri saptandõ. Otopside kalp hipertrofik bulundu (390 gr, saÛ ventrikŸl duvar kalõnlõÛõ: 0,7 cm., sol ventrikŸl duvar kalõnlõÛõ: 2,7 cm., septum kalõnlõÛõ: 2 cm.). Boßluklar, kapak•õklar ve koroner arter lŸmenleri doÛal olarak izlendi. Adale kesitlerinde sol ventrikŸlde yaygõn sedefi beyaz renkte alanlar mevcuttu. DiÛer organlarda nonspesifik bulgular gšzlendi. Mikroskopik incelemede kalpte adale liflerinin geniß alanda ortadan kalktõÛõ, yerini kollagen baÛ dokusunun aldõÛõ, liflerde hipertrofik gšrŸnŸm, akciÛerlerde amfizem bulgularõ, karaciÛerde pasif konjesyon, dalak parankiminde belirgin hiperemi ve fokal kanama saptandõ. Erken yaßta hipertrofik kalpte ortaya •õkan yaygõn fibrozis ve kalp yetmezliÛi bulgularõnõn ani kalp šlŸmŸ Ÿzerindeki etkisini, olgumuzun šzellikleri ile birlikte medikolegal a•õdan tartõßarak sunmayõ ama•lamaktayõz.Anahtar kelimeler: Kalp šlŸmŸ, miyokardiyal fibrozis, Ergen. SUMMARYOur case was 12 years old boy already dead during hospital admittance. He had been brought to the hospital after feeling suddenly sick while playing game. There was pin prick on the inner side of left nipple, and defibrilator spoon marks on the anterior chest wall. In external examination on macroscopic autopsy investigation heart was found hypertrophic (390 g weight, right ventricle wall thickness: 0,7 cm., left ventricle wall thickness: 2,7 cm., septum thickness: 2 cm.). Chambers, leaflets and coronary artery lumina were normal on examination. On myocardial sections wide white areas on left ventricle wall were detected. There were nonspesific macroscopic findings in the other organs. Heart muscle fibers disappeared on wide areas, collogenous connecting tissue replaced, heart muscle fibers hypertrophic, lung emphysema, passive liver congestion, spleenic paranchymal prominent hyperemia, focal bleeding had been investigated. On microscopic evaluation we aimed to discuss effect of fibrosis and cardiac failure findings of young hypertrophic hearts on sudden cardiac deaths in medicolegal aspects.