Vascular anomaly of the bundle of His associated with sudden death in a young man.
A 24-year-old black man suddenly collapsed while playing basketball. He died despite prompt cardiopulmonary resuscitation. The only abnormality found at autopsy was a vascular anomaly confined to the atrioventricular bundle of His within the cardiac conduction system. This arborizing collection of abnormal and increased number of blood vessels lacked both elastic fibers and smooth muscle, both of which were replaced by collagen. The number of vessels in the decedent's bundle of His was quantitatively compared with 117 normal controls by using a point-counting method. The percentage of points landing on vessels per total points counted (% VP/TP) in this man was 31% compared with 5.6 +/- 2.7% SD in the controls. No vascular malformations were seen elsewhere. This lesion has not been previously reported in the medical literature. This case confirmed the occasional usefulness of sampling the cardiac conduction system in sudden death with no obvious autopsy findings.
Bell
M D
MD
Palm Beach County Medical Examiner's Office, FL 33406.
Tate
L G
LG
D000328:Adult; D002036:Bundle of His / Q000002:abnormalities* / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male