[Morphology, frequency and significance of intramural arterial lesions in sudden coronary death (author's transl)].
In 208 selected cases of sudden coronary death (SD) and in 97 normal subjects dying from accident (AD) the intramural arterial vessels have been studied. In only one instance a unique "atheromatous" embolus was found. Arterial platelet aggregates (AP) were seen in 70% of SD and 76% of AD cases. The average number of arteria vessels with AP per section was 2.2 in SD and 2.5 in AD group (the range was 1 to 15 vessels). No correlation was found with the type of blood stasis and with a longer survival time. The conclusion is that AP are a secondary, terminal, non pathogenic phenomenon. This was documented by the findings in 39 cases of thrombotic thrombocytopenic purpura. In the latter, despite severe platelet sequestration and aggregation associated to other severely ischemic or hypoxic factors (obstructive microangiopathy, anemia, hemorrhagic diathesis, convulsive neurologic disorders) no evidence of coronary heart disease was shown. Other pathologic findings were "stenosing myo-fibrous medial hyperplasia" and more rarely intimal thickening, perivascular fibrosis and subintimal nodular hyalinosis. No one of these conditions predominated in SD cases. The conclusion is that the diseases of the small coronary arteries do not play any role in the nautral history of sudden coronary death.
D003327:Coronary Disease / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology; D003645:Death, Sudden / Q000473:pathology*; D006801:Humans
Morfologia, frequenza e significato patofisiologico delle lesioni intramurali nella morte improvvisa coronarica.