Sickle cell states and cardiomyopathy: Sudden death due to pulmonary thrombosis and infarction∗

Abstract

Sickle cell trait has become firmly established as a cause of significant morbidity and mortality. Four cases of sickle cell trait with fatal outcome are reported, and associated gross and microscopic pathologic findings are described. The striking association of myocardial structural derangement and massive pulmonary thrombosis has been delineated. Alcohol is suggested as a precipitating agent in the production of these catastrophic events in the susceptible person with sickle cell trait, and a possible explanation for their synergistic effects has been discussed.