Abstract

CARRATALA CALVO, F.; ORTIZ CRIADO, JM.; PRESENTACION BLASCO, C. de la  and  MOLINA AGUILAR, P.. Nonatherosclerotic coronary artery disease presenting as sudden death in adults: Casuistic from the Institute of Legal Medicine of Valencia (Spain) (1997-2005). Cuad. med. forense [online]. 2005, n.42, pp.307-316. ISSN 1988-611X.

Introduction and objectives. Coronary atherosclerosis is the most frequent cause of acute myocardial ischemia and sudden cardiac death in industrialized countries. However, there are others diseases, congenital or acquired, that can produce myocardial ischemia and sudden death: anomalous origin, hypoplasia, ostial stenosis, aneurysms, dissections, high take-off, myocardial bridges, vasculitis. The aim of this paper is to review the frequency and characteristics of nonatherosclerotic coronary artery disease in 8003 forensic autopsies performed at the Institute of Legal Medicine of Valencia (Spain) between 1997-2005. Method: The criteria for the case selection have been: - subjects over 14 years old, sudden death caused by nonatherosclerotic coronary artery disease and circumstances of death compatible with the definition of sudden death. Results. Nine cases of sudden cardiac death have been found in adults of which two (2) cases of myocardial bridges, six (6) cases of coronary dissection and one (1) case of anomalous origin. Conclusions. Although non-atherosclerotic coronary artery disease is a rare cause of sudden cardiac death, we must be aware of it and be able to diagnose it in the autopsy-room. Other possible causes of death should always be eliminated through additional complementary chemo-toxicological- and histological analysis. It is important to obtain the maximum amount of clinical information, which will assist the diagnosis of this type of pathology, since in most cases it continues to be a post-mortem finding.

Keywords : Coronary artery disease; sudden cardiac death; forensic pathology.

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