Histopathological Spectrum of Cardiac Lesions in Sudden Cardiac DeathAn Autopsy Study

Abstract

Introduction: Sudden Cardiac Death (SCD) is a serious health concern, and the incidence of SCD is rising globally. A number of causes can result in SCD in apparently healthy individuals and in people with undiagnosed cardiac disease. The study was done to evaluate the probable cause of death by observing various histomorphological changes in cardiac autopsies. Aim: To establish the cause of SCD and study the histopathology, age and sex distribution, frequency, and location of different types of cardiac lesions. Materials and Methods: The study was a descriptive, crosssectional, observational study carried out in the Department of Pathology and Forensic Medicine and Toxicology (FMT) at PRM Medical College and Hospital, Baripada, Odisha, over a period of three years. Gross and microscopic findings on Haematoxylin & Eosin (H&E)-stained cardiac sections were studied. The final diagnosis was made on the basis of clinical, autopsy, and histopathological findings. The study was compared with other relevant studies. The data was analysed using Microsoft Excel 2019 software. Results: A total of 164 cases of SCD were included in this study. The maximum number of deaths occurred in the age group of 51-60 years (42 cases). The male to female ratio was 2.6:1, indicating an overall male preponderance. Out of 164 autopsied hearts, 85 cases of Ischemic Heart Disease (IHD), including new, old, and mixed lesions were found, followed by Hypertrophic Cardiomyopathy (HCM) in 25 cases, multiple lesions in 12 cases, dilated cardiomyopathy in four cases, tubercular pericarditis with myocarditis in one case, infective endocarditis in three cases, atherosclerosis in one case, coronary insufficiency in one case, cardiac myxoma in one case. Conclusion: Many factors can lead to SCD in apparently healthy individuals or in people with cardiac disease. In the present study, the most common cause contributing to SCD was IHD. The cause of SCD can be identified by a thorough post-mortem examination and histological analysis.