Sudden cardiac death in young people – forensic medical relevance

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Article Title: Sudden cardiac death in young people – forensic medical relevance
Authors: Bulzan O., Pribac G.C., Precup C., Enache A.
Affiliation: “Victor Babeș”University of Medicine and Pharmacy, Timisoara, Romania
“Vasile Goldis” Western University, Arad, Romania
University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
Abstract: In accordance with the forensic criteriology, but also juridical, death can be defined as the physiological process triggered by violent or non-violent causes and characterized with the ceasing of vital functions, which causes the formation of the irreversible damage to the central nervous system, and finally, the disappearance of the individual as a biological entity. The non-violent death is the death which is produced without violating the right to life of the human being and without the intervention of a traumatic agent outside the body. Sudden death is included in the category of deaths suspected of being violent. According to the recent specialized data, numerous cardiac conditions with identifiable correspondent within the histopathological microscopic exam, situated at the origin of cardiac sudden death are genetically determined. In the category of sudden deaths, the most common are those of cardiac origin (approximately 80%, most of the victims being males – approximately 70-75%). In the study were examined the permanent histological preparations obtained from 347 of forensic autopsies. From these, 201 (57.92%) were cases of violent death, and 146 (42.07%) were cases of non-violent death. From the cases of non-violent death, 14 have been of cardiac origin, in which case death occurred before the age of 45 years. The histopathological elements followed were: early myocardial ischemia, acute myocardial heart failure, acute endocarditis, acute myocarditis and acute pancarditis (acute organic diseases which may cause sudden death) and coronary atherosclerosis, myocardosclerosis, myocardofibrosis, subepicardic myocardial lipomatosis (chronic organic lesions which through decompensation may cause sudden death). In the same study, is currently ongoing genetic tests (the sequencing stage) for identifying the mutations likely to be involved in the tanato-generator mechanism of sudden death of cardiac origin; the DNA sources used being represented by the histopathology preparations archived (paraffin blocks) from the cases which were examined microscopically. The correlation of the tanato-generator histopathological elements identifiable microscopically, (coronary atherosclerosis, subepicardic myocardial lipomatosis, myocardofibrosis, myocardosclerosis, acute myocarditis, acute endocarditis, pancarditis, heart failure) with the results of the genetic tests will allow to register timely therapeutically the relatives of the victims of sudden cardiac death for the prevention of other deaths.
Keywords: sudden cardiac death, forensic, pathology
*Correspondence: Ovidiu Bulzan, “Victor Babeș”University of Medicine and Pharmacy, Timisoara