Abstract
The article provides an assessment of changes in the endocardium of the atria and ventricles of the heart in cases of sudden cardiac death due to acute coronary insufficiency. In cases of sudden death due to acute coronary insufficiency, distinct focal pathological changes were observed in the connective tissue of the endocardium of the left atrium and ventricle, manifested by loss of fibrillar structures and fragmentation of its non-cellular elements. This corresponded to local contractile changes in the cardiomyocytes, localised in the subendocardial space of the affected parts of the heart, leading to local fragmentation and an increase in the thickness of the endocardial folds. In addition, the loss of their characteristic waviness and the acquisition of linearity were observed. These changes are considered to be manifestations of morpho-functional disorders of the endocardium of the specified heart segments. The aim of the study was to determine the characteristics of endocardial changes in the atria and ventricles in cases of sudden death due to acute ischaemic heart disease. Materials and Methods. The study material included 12 hearts from young and middle-aged individuals without cardiovascular disease (control group) and 12 hearts from working-age individuals who died suddenly of acute ischaemic heart disease. Conclusions: At the time of death from acute ischaemic heart disease, there were pronounced focal pathological changes in cellular and non-cellular components in the connective tissue of the endocardium of the left atrium and ventricle. These changes caused focal contractile changes in cardiomyocytes localised in the subendocardial layer of the myocardium of the left ventricle. The identified changes in the subendocardial layer of the myocardium caused focal thickening, fragmentation, and increased thickness of the endocardial folds, their undulation, which can be considered as manifestations of morpho-functional disorders of the endocardium.
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