Pathologic changes in the cardiac conduction and nervous system in sudden coronary death.
The arrhythmogenic substrates for sudden coronary death were studied in 13 autopsied hearts and in 2 left stellate ganglia (surgically excised). Diffuse or segmentary obstruction of nutritional arteries accounted for acute ischemic injury of the conduction system, which was the underlying cause of high-risk bradycardic arrhythmias in one-third of the cases. However, in one-quarter of the cases the survival of anoxia-resistant subendocardial specialized fibers was probably responsible for reentrant lethal tachycardic arrhythmias. In other cases, early infarct damage could have fatal arrhythmias of either type. Intrinsic and/or extrinsic neuropathologic changes, unbalancing the autonomic action on the heart, were often seen to participate in the arrhythmogenic features of sudden coronary death.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D001283:Atrioventricular Node / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D003327:Coronary Disease / Q000150:complications / Q000401:mortality* / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology* / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D012849:Sinoatrial Node / Q000473:pathology / Q000503:physiopathology; D013233:Stellate Ganglion / Q000473:pathology / Q000503:physiopathology