Histopathological spectrum of cardiovascular findings in forensic autopsies in Hadoti region: A prospective study of one year

Abstract

Heart diseases are now the biggest killer in the world. Many cardiovascular pathologies are concealed and found incidentally on post mortem examination. To analyse spectrum of histopathological lesions (related or unrelated to cause of death) in heart autopsies in Hadoti region of Rajasthan. This was a one year prospective hospital-based study. A total of 133 whole heart specimen underwent detailed gross and microscopic examination. Most common histopathological finding was atherosclerosis, seen in 63 cases out of 133 autopsied hearts (47.3%), followed by myocardial hypertrophy in 31 cases and myocardial infarction in 20 cases. Age related changes were seen in 10 cases, severe congestion in 10 cases, myocardial fibrosis in 7 cases. 1 case each of infective endocarditis, myocardial calcification, ventricular rupture, myocarditis, LAD stent, fat embolism was noted. 51 hearts did not reveal any sort of pathology. Correlation of age with atherosclerosis showed a significant p value (0.0009). Males showed a slightly higher prevalence of atherosclerosis but it was not statistically significant. We had 39 (29.3%) cases of sudden cardiac deaths (SCD). SCD cases showed similar histopathological spectrum as all other causes of deaths, but percentage of each heart pathology was much higher in SCD. Most common finding among SCD cases was coronary artery disease (23 cases), followed by myocardial hypertrophy (22 cases) and myocardial infarction (13 cases). Myocardial Fibrosis was seen in 3 cases, age related changes in 2 cases, ventricular rupture in 1 case and severe congestion in 1 case. 61.5% SCD cases showed combination of two or more pathologies. Five SCD cases did not reveal any pathology.In our study heart pathologies make a major contribution towards ill health and death in our society, atherosclerosis being the most common finding.