Comparison of heart wall thickness and valve measurements between deaths from acute myocardial infarction and other causes aim

Aim Death is an inseparable part of existence and a natural process in the flow of life that every living being will encounter. Doctors who will work in all branches of medicine can face deaths during their students' and / or professional lives. Therefore, in order to respond to legal and other problems related to death, medical doctors should evaluate death not only in terms of medical aspects but also in a holistic approach and understand the process of death. Sudden deaths although described as "deaths that occur within 24 hours after the onset of symptoms" by the World Health Organization; various definitions have been made of sudden unexpected deaths, and these definitions are always intertwined. It is the sudden death of a person whose current disease is unknown to him and his surroundings. Acute MI is defined as myocardial cell death due to oxygen deficiency due to prolonged ischemia. It is used if there is evidence of myocardial necrosis in association with clinical findings consistent with acute myocardial ischemia. Myocardial infarction classified as ST-segment elevation (STEMI) and non ST-segment elevation (NSTEMI). Risk factors for acute MI are divided into three general categories. These include non-modifiable risk factors (age, gender and family history), modifiable risk factors (smoking, alcohol intake, physical inactivity, poor nutrition, hypertension, diabetes, dyslipidemia and metabolic syndrome, etc.), and subsequent life-style risk factors ( C-reactive protein (CRP), fibrinogen, coronary artery calcification (CAC), homocysteine, lipoprotein a and LDL). In this study, we aimed to investigate whether heart weight, wall thickness and valve measurements had any effect on acute MI. Material and Method The reports of autopsies performed between 2015-2016 at the Forensic Medicine Institute Malatya Forensic Medicine Group were reviewed retrospectively. In the autopsy files, cases diagnosed as acute myocardial infarction as a result of pathological examination and those who did not die due to any heart disease or heart pathology were determined were selected and two groups were formed. The factors that could affect the heart sizes between the two groups were minimized. For this purpose, groups were formed with equal gender distributions. Age, height, weight, and body mass index (BMI) were chosen for each group to be very close to each other. Heart weights, left and right ventricular wall thickness, aortic, pulmonary and mitral, tricuspid valve measurements, right, left, anterior descending and circumflex coronary arteries were compared. Data were analyzed with IBM SPSS 21.00. Results Both groups consisted of 23 men and 5 women. Age, height, weight, and body mass index were chosen to be very close to each other. The mean age was 51 ± 21 in the acute MI group and 50 ± 20 in the control group. The mean height and weight were calculated as 171 ± 11 and 77 ± 15 for the acute MI group and 170 ± 11 and 76 ± 17 for the control group. BMI was 27 ± 7 in the acute MI group and 26 ± 6 in the control group. The mean left ventricular wall thickness was 1.461 ± 0.2767 in the acute MI group and 1.386 ± 0.2460 in the control group. In independent groups, t test was calculated as p: 0.289 and the difference was not statistically significant. The median right ventricular wall thickness was calculated as 0.4 centimeters (cm) in the acute MI group, with a minimum of 0.2 cm and a maximum of 0.6 cm. In the control group, the median was calculated as 0.3 cm, with a minimum of 0.2 cm and a maximum of 0.7 cm. As a result of Mann Whitney U test; p: 0.171 and the difference was not statistically significant. Conclusion There is not much research on wall thickness and valve measurements among acute MI risk factors. In autopsy series, we investigated whether wall thickness and valve measurements could be risk factors for acute MI and although the mean values were elevated, this height was not statistically significant. Keywords: Sudden death, acute MI, heart weight, wall thickness, valve measurements, autopsy