ALLERGIC MYOCARDITIS - AS CAUSE OF DEATH IN SUDDEN CARDIAC DEATH FORENSIC PATHOLOGY
Authors: Al. Enache
Aim: The study was based on the cardiac changes which occurred in cases of sudden cardiac death through anaphylactic shock with distinctive lesions.
Materials and Methods: We analyzed the cases of sudden cardiac death which happened immediately after exposure to different allergens (insect bites, microorganisms, drugs, proteins). We excluded all cases with previous heart disease and those with associated diseases. The investigations were mainly microscopic analyses of H&E sections.
Results: 7 cases of sudden cardiac death by anaphylactic shock were autopsied. The main diagnosis was one of exclusion, acute cardiac changes intervened in the pathological sequence leading to death. We observed dissecting cardiac edema, undulations and ruptures of myocardial fibers, small interstitial and interfibrillar haematic extravasations cu leukocytic influx. The cases bring up changes bearing similarities to Kounis Syndrome.
Conclusions: The cases of sudden cardiac death with an anaphylactic initiation require a careful surveillance of the cardiac changes (which can be considered as belonging to an allergic myocarditis) as an important part of the pathology leading to death.