Author(s): Kiran Kumar Patnaik1, Manoj Kumar Patro2
Among the unexpected and undiagnosed sudden deaths, incidence of Ischaemic Heart Disease (IHD) is very high. Appearance of characteristic morphological and histopathological changes in the myocardium due to IHD is often delayed. As such, opining as to the cause of death at autopsy also becomes very difficult. The objective of the present study is to evaluate the role of gross morphological, histopathological and biochemical (Cardiac Troponin I) parameters in ascertaining the cause of death to IHD.
MATERIALS AND METHODS
The present study was a prospective study carried out on a total of 63 consecutive bodies received for post-mortem examination with the history of sudden deaths. After opening the thoracic cavity, blood sample was collected from the cardiac chambers and used for cardiac Troponin I level estimation. A thorough gross examination was done in all the cases and tissue bits from representative sites were histopathologically evaluated.
Out of the total 63 cases, 38 had past history suggestive of IHD. Characteristic gross morphological changes were found only in 58% of cases whereas with the addition of histopathological findings 84% cases could be diagnosed. Cardiac Troponin I level was elevated i.e. tests positive in all the 38 cases with history suggestive of IHD whereas the remaining 25 cases without prior history of IHD were found to be negative.
Estimation of serum Cardiac Troponin I levels has been found to be a very useful and sensitive marker of early ischaemic damage to the heart particularly when there is lack of gross morphological and histopathological findings. This could be a significant diagnostic parameter coupled with gross morphological and histological changes in sudden deaths relating to IHD.