Cardiac arrhythmias
Cardiac arrhythmias, especially ventricular ones, are a mechanism associated with sudden natural death.
General
Associations
- Myocardial infarction.[1]
- Hypertensive heart disease.[2]
- Commotio cordis.
- Arrhythmogenic right ventricular cardiomyopathy.
Non-cardiac
- Electrocution.
- Hyperthermia.
Microscopic
Features - associated with ventricular fibrillation:[3]
- Myofiber break-up (MFB) - key feature.
- Fractures of the sarcomeres perpendicular to the long axis.
- Associated with square nuclei.
Notes:
- In cases with malignant arrhythmias, as shown by cardiac monitor at the time of death, MFB is seen in multiple sections.[3]
- MFB seems to be predominantly mid-myocardial/epicardial, with relative sparing of the subendocardium.[citation needed]
Images
MFB - intermed. mag. (WC)
MFB - high mag. (WC)
MFB - very high mag. (WC)
MFB - very high mag. (WC)
References
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 293. ISBN 978-1416054542.
- ↑ Prisant LM (April 2005). "Hypertensive heart disease". J Clin Hypertens (Greenwich) 7 (4): 231–8. PMID 15860963.
- ↑ 3.0 3.1 Baroldi, G.; Silver, MD.; Parolini, M.; Pomara, C.; Turillazzi, E.; Fineschi, V. (Apr 2005). "Myofiberbreak-up: a marker of ventricular fibrillation in sudden cardiac death.". Int J Cardiol 100 (3): 435-41. doi:10.1016/j.ijcard.2004.10.007. PMID 15837088.