Sudden Death Related to Small Coronary Artery Disease

Michaud, Katarzyna; Romain, Nathalie; Brandt-Casadevall, C.; Mangin, Patrice

doi:10.1097/00000433-200109000-00003

Cited by 30 publications

(10 citation statements)

References 8 publications

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“…FMD of the nodal arteries was seen affecting young and old individuals alike; in both the study by Charlton et al 3 Two cases of sudden death were seen in young individuals described by Michaud et al 8 and 1 case was described by Zack et al 9 Michaud et al 8 described FMD of the nodal artery as a lesion often entirely seen within the tunica media, including the present study. However, other degenerative changes like fibrosis and fat infiltration were seen more in the elderly in the present study, and was similar to the findings of Charlton et al 3 and Suarez-Mier et al…”

Section: Discussionsupporting

confidence: 67%

“…No other significant pathology was detected in their hearts. So in all these cases we can safely assume that FMD of the nodal artery would have lead to electrical instability and sudden death, as stated in the literature [8][9][10][11] .…”

mentioning

confidence: 81%

“…This study illustrated the importance of examination of the intramural coronary arteries and the nodal arteries, particularly in cases of sudden death of young people who die without any obvious cause. 8 Zach et al 9 examined the conduction system in a 12 year old boy who collapsed suddenly and died. The only abnormality detected was the extreme narrowing of the AV nodal artery with proliferation of smooth muscle cells with fibrosis of the media and partly of the intima.…”

mentioning

confidence: 99%

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Cardiac conduction system- A detailed study in 46 cases of sudden death

Ilias¹,

Pai²,

Shukla³

et al. 2015

J Pathol Nep

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Background: Atherosclerotic coronary artery disease is the modern pandemic and is said to be responsible for a major chunk of sudden cardiac deaths. However, in few cases; especially among the young, conduction system abnormalities were found to be the cause of death with absence of significant coronary lesions. These days, examination of the cardiac conduction system during autopsy has been abandoned as it is said to be a time consuming process. The present study was undertaken to highlight the importance of examining the cardiac conduction system in all sudden death cases.Materials and Methods: This study was a prospective one, conducted from June 2007 to June 2009 in the department of Pathology, Kasturba Medical College, Mangalore. Forty six hearts of persons who died suddenly were studied.Results: Our study showed that even though atherosclerotic coronary lesions were the most common cause of sudden death, cardiac conduction defects also contributed to a significant number of cases; especially in the young. In our study of 46 cases; 6 cases showed only conduction system abnormalities. These were young adults who had died suddenly. The predominant lesion identified in them was fibromuscular dysplasia of the nodal arteries.Conclusion: A detailed examination of the coronaries and the cardiac conduction system should be made mandatory in all sudden death cases, especially in the young as they will help to throw some light into the cause of death.Journal of Pathology of Nepal (2015) Vol. 5, 709-716

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Section: Discussionsupporting

confidence: 67%

mentioning

confidence: 81%

mentioning

confidence: 99%

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Cardiac conduction system- A detailed study in 46 cases of sudden death

Ilias¹,

Pai²,

Shukla³

et al. 2015

J Pathol Nep

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“…40,42 More so, autopsy studies have identified FMD in the coronary arteries of young patients with sudden death. 43 The propensity for SCAD to occur at times of sex hormone level alteration (peripartum status, fertility treatment) might suggest a direct hormonal effect on the coronary vasculature, although certain proteoglycan changes that occur after pregnancy may not occur with other hormonal manipulations. That said, only a minority of such women experience SCAD.…”

Section: Tweet Et Al Spontaneous Coronary Artery Dissection 585mentioning

confidence: 99%

Clinical Features, Management, and Prognosis of Spontaneous Coronary Artery Dissection

et al. 2012

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Background-Spontaneous coronary artery dissection (SCAD) is an acute coronary event of uncertain origin. Clinical features and prognosis remain insufficiently characterized. Methods and Results-A retrospective single-center cohort study identified 87 patients with angiographically confirmed SCAD. Incidence, clinical characteristics, treatment modalities, in-hospital outcomes, and long-term risk of SCAD recurrence or major adverse cardiac events were evaluated. Mean age was 42.6 years; 82% were female. Extreme exertion at SCAD onset was more frequent in men (7 of 16 versus 2 of 71; PϽ0.001), and postpartum status was observed in 13 of 71 women (18%). Presentation was ST-elevation myocardial infarction in 49%. Multivessel SCAD was found in 23%. Initial conservative management (31 of 87) and coronary artery bypass grafting (7 of 87) were associated with an uncomplicated in-hospital course, whereas percutaneous coronary intervention was complicated by technical failure in 15 of 43 patients (35%) and 1 death. During a median follow-up of 47 months (interquartile range, 18 -106 months), SCAD recurred in 15 patients, all female. Estimated 10-year rate of major adverse cardiac events (death, heart failure, myocardial infarction, and SCAD recurrence) was 47%. Fibromuscular dysplasia of the iliac artery was identified incidentally in 8 of 16 femoral angiograms (50%) undertaken before closure device placement and in the carotid arteries of 2 others with carotid dissection. Conclusions-SCAD affects a young, predominantly female population, frequently presenting as ST-elevation myocardial infarction. Although in-hospital mortality is low regardless of initial treatment, percutaneous coronary intervention is associated with high rates of complication. Risks of SCAD recurrence and major adverse cardiac events in the long term emphasize the need for close follow-up. Fibromuscular dysplasia is a novel association and potentially causative factor. (Circulation. 2012;126:579-588.)

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“…Spontaneous coronary artery dissection (SCAD) may be superimposed on CFMD leading to acute coronary syndrome (ACS) [1]. Importantly, CFMD has been associated with nonatherosclerotic myocardial ischemia and sudden death [2,3]. We report a case of spontaneous coronary artery dissection in the setting of coronary fibromuscular dysplasia.…”

Section: Introductionmentioning

confidence: 99%