title: [Myocardial pathology in sudden ischemic death: peculiarities of morphologic diagnosis].
abstract: OBJECTIVE
  The aim of the investigation was to determine morphological criteria of acute myocardial injures in sudden ischemic death.
  
  
  METHODS
  Morphological investigation of the whole myocardium and coronary arteries in 170 victims of sudden out-of-hospital death due to ischemic heart disease was performed in the framework of the international WHO program "Myocardial Infarction Register in Population" and joint (at that time) USSR-USA project on sudden death.
  
  
  RESULTS
  It was established, that out-of-hospital sudden death due to ischemic heart disease in all cases is related to irreversible myocardial injury: 92.9% - to acute myocardial infarction, and 7.1% - to micronecrosis. The following phases of morphological development of infarction were determined: early myocardial infarction--in 48.8, definite--in 21.8, and progressing--in 22.3%. Since the signs of early infarction were also found in 34 cases of progressing myocardial infarction, it was reasonable to suppose that in 117 (71.1%) patients the occurrence of sudden out-of-hospital death due to ischemic heart disease was somehow connected with the very early and early phases of acute myocardial infarction.
  
  
  CONCLUSIONS
  Accurate identification of early myocardial infarction is available only by microscopic investigation of histotopograms of the whole myocardium considering the complex of signs of cardiomyocyte alteration as well as early inflammatory reaction. Acute pathology (erosion or rupture of atherosclerotic plaque and thrombosis) of "culprit" coronary artery indirectly indicates regional myocardial irreversible injury.
authors.affiliation: Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
authors.forename: Elena
authors.initials: E
authors.lastname: Stalioraityte
authors.forename: Dalia
authors.initials: D
authors.lastname: Pangonyte
authors.forename: Juozas
authors.initials: J
authors.lastname: Bluzas
authors.forename: Marija
authors.initials: M
authors.lastname: Gedminiene
authors.forename: Genovaite
authors.initials: G
authors.lastname: Korsakiene
authors.forename: Danute
authors.initials: D
authors.lastname: Kazlauskaite
authors.forename: Jolita
authors.initials: J
authors.lastname: Palubinskiene
mesh_terms: D000328:Adult; D001344:Autopsy; D016757:Death, Sudden, Cardiac / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D017202:Myocardial Ischemia / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D014944:World Health Organization