Forensic Sciences and Growth of Cardiology

Abstract

th century. Harvey’s discovery was made possible by the lift of ban on medical autopsies. Harvey was a pioneer in recognizing that clinic-pathologic correlations from postmortem findings are pivotal in gaining anatomical knowledge and recognizing the basis of clinical symptoms and signs. Andreas Vesalius, a predecessor of Harvey had noted marked differences between Galen’s teaching and the real anatomy from observations in dissected human bodies. He traced the elaborate network of the blood vessels and accurately described the anatomy of the heart [1]. The significance of the approach of these two path finders is evident from the observations that over centuries, there has been no significant decrease in the rate of unexpected findings detected in either medico-legal autopsies or postmortem studies on patients dying from natural causes in hospitals [2,3]. Autopsy studies have contributed immensely to our understanding of the anatomical basis of a number of heart diseases. A large number of heart diseases such as myocarditis, and carcinoid heart disease were first described during autopsies. Several infections that are not diagnosed clinically have been detected at autopsy for the first time as causes for cardiac symptoms and signs [4]. We recognize at present that influenza and pneumonia can trigger acute vascular events and increase the risk of myocardial infection. Studies have linked pre-eclampsia, a major cause of death due to vascular factors to maternal infection. It was through autopsy studies that Chaga’s disease was recognized as a cause for cardiomyopathy as well as for sudden death in patients with asymptomatic infection with T. Cruzi [5,6]. Pathological features of another tropical problem rheumatic heart disease were clarified through post-mortem observations. Autopsy studies aided in understanding the pathogenesis of chronic valve disease, effects of mitral valve replacement and valve repair as well as the causes for failure of such treatment in patients with rheumatic valve disease. Complex congenital heart diseases such as tetralogy of Fallot, transposition of the great vessels, tricuspid atresia, hypoplastic left heart syndrome, coarctation of the aorta, hypoplastic right heart syndrome, anomalous position of the heart, endocardial cushion defects and tricuspid valve dysplasias have all been characterized during postmortem examinations [7,8]. Post mortem studies on adults with congenital heart diseases and who have underwent surgical corrections could provide novel information and guidance for revision of present approaches to management of patients with congenital heart defects [9].