[Immunohistochemical diagnostic management of early stages of myocardial infarction for the purposes of postmortem medicolegal examinations].
A postmortem diagnosis of a "well developed" myocardial infarction is not difficult. In the initial stages of infarction, however, at the stage of gross examination it is impossible to discriminate between the infarcted zone and the undamaged cardiac muscle. When a cardiogenic cause of death is suspected, this fact determines the method of material collection and the amount to be collected, as well as further examinations to be performed. The histopathological diagnosis of a "fresh" myocardial infarction employing a basic routine staining method (hematoxylin/eosin) is not sufficient either. This makes it necessary to use additional special staining techniques to resolve diagnostic problems, thus verifying the precise diagnosis. The aim of this research was to introduce the immunohistochemical C9 staining technique as a postmortem diagnostic method of detecting recent myocardial infarctions for the purpose of postmortem medicolegal examinations, to develop the principles of result interpretation and to compare the said technique with the previously used Nielsen-Selye staining method. The specimens examined were collected from the heart muscle in 90 autopsy cases: cases of myocardial infarction positively diagnosed during autopsies and verified by routine staining examination (5); clinically positively diagnosed cases of myocardial infarction, without autopsy verification and examined microscopically using the routine staining method (5); sudden deaths with symptoms of acute circulatory failure due to cardiac causes (50) and the controls (30). The investigation demonstrated the specificity of the immunohistochemical C9 staining method in cases of myocardial damage associated with focal ischemia. It also confirmed the higher usefulness of the immunohistochemical method as compared to the Nielsen-Selye staining method in postmortem diagnostics of recent stages of myocardial infarction.
Rzepecka-Woźniak
Ewa
E
Z Katedry Medycyny Sadowej Uniwersytetu Jagiellońskiego Collegium Medicum.