Histopathological Findings in Sudden Cardiac Death: 5-years Autopsy Experience in a Tertiary Hospital in Bandung, Indonesia

Gian Nugraha; Nita Novita; Hermin Aminah Usman

doi:10.15850/amj.v8n2.2324

Histopathological Findings in Sudden Cardiac Death: 5-years Autopsy Experience in a Tertiary Hospital in Bandung, Indonesia

Gian Nugraha, Nita Novita, Hermin Aminah Usman

Abstract

Background: Sudden death (SD) is a sudden and unexpected death with an unknown cause. However, it has been assummed that the most common causes of sudden deaths are cardiovascular or non-cardiovascular causes such as gastrointestinal disease, respiratory disease, genitourinary disease, epilepsy, and trauma. This study aimed to portray histopathological findings and causes of sudden cardiac death (SCD) cases based on 5 year autopsy experience in a tertiary hospital in Bandung, Indonesia.

Methods: This study was a descriptive cross-sectional study exploring causes of SCD from 2015 to 2019 at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. All medical records with SCD and histopathology findings were retrieved from September to December 2020. Only cases with histopathological examination results were included.

Results: SCD was found in 7 of 16 patients with sudden death. Coronary atherosclerosis was the most common (n=4), followed by myocardial infarction (n=2) and ruptured aortic aneurysm (n=1). Myocarditis and calcific aortic valve diseases were not found.

Conclusions: In this study, the most common cause of SCD is coronary atherosclerosis, which is identified mainly in older and male patients.

Keywords

Autopsy; forensic; coronary atherosclerosis; sudden cardiac death

Full Text:

PDF

References

Suryadi T. Penentuan sebab kematian dalam visum et repertum pada kasus kardiovaskuler. Jurnal Averrous. 2019;5(1):63–75.

Saukko P, Knight B. Knight’s forensic pathology. 4th Edition. Boca Raton: Taylor & Francis; 2016.

Nofal HK, Abdulmohsen MF, Khamis AH. Incidence and causes of sudden death in a university hospital in Eastern Saudi Arabia. East Mediterr Health J. 2011;17(9):665–70.

Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death. Circulation. 2012;125(4):620–37.

Isbister J, Semsarian C. Sudden cardiac death: an update. Intern Med J. 2019;49(7):826–33.

Parakh N. Sudden cardiac death. J Pract Cardiovasc Sci. 2015;1(2):113–9.

Wong CX, Brown A, Lau DH, Chugh SS, Albert CM, Kalman JM, et al. Epidemiology of sudden cardiac death: global and regional perspectives. Heart Lung Circ. 2019;28(1):6–14.

Suryadi T. Kematian mendadak kardiovaskuler. Jurnal Kedokteran Syiah Kuala. 2017;17(2):112–8.

Fellmann F, van El CG, Charron P, Michaud K, Howard HC, Boers SN, et al. European recommendations integrating genetic testing into multidisciplinary management of sudden cardiac death. Eur J Hum Genet. 2019;27(12):1763–73.

Campuzano O, Allegue C, Partemi S, Iglesias A, Oliva A, Brugada R. Negative autopsy and sudden cardiac death. Int J Legal Med. 2014;128(4):599–606.

Henky H, Que A, Yulianti K, Rutyadi D, Alit IBP. Penurunan angka autopsi di RSUP Sanglah selama delapan tahun terakhir. Jurnal Forensik dan Medikolegal Indonesia. 2019;1(2):50–5.

Basso C, Aguilera B, Banner J, Cohle S, d’Amati G, de Gouveia RH, et al. Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology. Virchows Arch. 2017;471(6):691–705.

de la Grandmaison GL, Charlier P, Durigon M. Usefulness of systematic histological examination in routine forensic autopsy. J Forensic Sci. 2010;55(1):85–8.

Yazdanfard PD, Christensen AH, Tfelt-Hansen J, Bundgaard H, Winkel BG. Non-diagnostic autopsy findings in sudden unexplained death victims. BMC Cardiovasc Disord. 2020;20:58.

Rorora JD, Tomuka D, Siwu J. Temuan otopsi pada kematian mendadak akibat penyakit jantung di BLU RSU Prof. Dr. R. D. Kandou Manado periode 2007-2011. Jurnal e-Clinic. 2014;2(3):6037.

Sara JD, Eleid MF, Gulati R, Holmes DR. Sudden cardiac death from the perspective of coronary artery disease. Mayo Clin Proc. 2014;89(12):1685–98.

Jinnouchi H, Sato Y, Sakamoto A, Cornelissen A, Mori M, Kawakami R, et al. Calcium deposition within coronary atherosclerotic lesion: implications for plaque stability. Atherosclerosis. 2020;306:85–95.

Ghafoor M, Kamal M, Nadeem U, Husain AN. Educational case: myocardial infarction: histopathology and timing of changes. Acad Pathol. 2020;7: 2374289520976639.

Jazayeri MA, Emert MP. Sudden cardiac death: who is at risk? Med Clin North Am. 2019;103(5):913–30.

Tzoulaki I, Elliott P, Kontis V, Ezzati M. Worldwide exposures to cardiovascular risk factors and associated health effects: current knowledge and data gaps. Circulation. 2016;133(23):2314–33.

DOI: https://doi.org/10.15850/amj.v8n2.2324