Evaluation of pathology of the cardiac conduction system in sudden unexpected deaths

ABSTRACT Evaluation of Pathology of the Cardiac Conduction System in Sudden Unexpected Deaths The deaths of which causes can not be determined through the external examination and scene investigation are defined as "sudden unexpected deaths". This deaths are common problems in Forensic Medicine. Cases of sudden unexpected death may be grouped according to the autopsy findings and laboratory tests. The first is natural deaths and the other group is unnatural deaths. Also, in some cases, no lesion is found at autopsy and laboratory tests. It is said that some abnormalities of the cardiac conduction system may cause or contribute to sudden unexpected deaths. Fibrofatty changes and dysplasia of the node arteries are found in the studies of cardiac conduction system in sudden unexpected deaths. It is claimed that this changes can cause death. Totally 31 cases -aged between 14 and 78- whose autopsies are performed at the Council of Forensic Medicine of Adana, Morgue Department were selected. 27 of 31 cases were sudden unexpected death and 4 of 31 cases were selected as control group. The samples of the SA and AV nodes were collected from all of the cases. All sections were stained by routine Hematoxylin and Eosin, and special histochemical staining methods (Masson's Trichrome, Elastic- Van Gieson and Crystal Violet), and examined under light microscopy. In 27 sudden unexpected deaths, pathological fibrozis was observed in SA node (7 cases) and AV node (7 cases). Pathological fatty infiltration was detected in SA node (8 cases) and AV node (7 cases). 3 of the cases had lethal cardiac conduction system lesions. The aim of this study is to try to find out effects of the cardiac conduction system in sudden unexpected death cases and to determine conduction system findings and local characteristics. Keywords: Autopsy, Cardiac Conduction System, Histopathology, Sudden Unexpected Death. IX