Histological findings of the atrioventricular conductive system in street heroin addicts, victims of sudden unexpected death.
A study of the atrioventricular (AV) conducting tissue was considered necessary for the examination of probable histologic changes that could justify the arrhythmias observed in street-heroin addicts. Postmortem coronary angiography and microscopic examination were performed in 50 heroin addicts (group A) and in 50 nonaddicts (group B), all male 16-40 years old. In group A, fatty and/or fibrous tissue replaced the AV node in 50% of cases while in group B in 14%. The main bundle was replaced by fatty and/or fibrous tissue in 44% in group A cases and 10% in group B. Intimal proliferation and fibromuscular dysplasia of the AV arteries in group A were correspondingly 26% and 14% and in group B 6% and 2%. Inflammation with focal and/or diffuse concentration of round cells of the AV node was detected in 54% in group A. These findings could explain a possible arrhythmia mechanism in this population.
Forensic Medical Service of Athens, Mikras Asias 75, GR-115 27, Athens, Greece. theano9@otenet.gr
Christos E
CE
Nerantzis
Constantinos M
CM
Couvaris
Socrates C
SC
Pastromas
Soultana K
SK
Marianou
Ilias D
ID
Boghiokas
Philippos N
PN
Koutsaftis
D000293:Adolescent; D000328:Adult; D001283:Atrioventricular Node / Q000473:pathology*; D002036:Bundle of His / Q000473:pathology*; D016022:Case-Control Studies; D003287:Contrast Media; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology; D003645:Death, Sudden / Q000473:pathology*; D005352:Fibromuscular Dysplasia / Q000473:pathology; D005355:Fibrosis / Q000473:pathology; D049429:Forensic Pathology; D006556:Heroin Dependence / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D009206:Myocardium / Q000473:pathology; D011689:Purkinje Cells / Q000473:pathology; D017539:Tunica Intima / Q000473:pathology; D055815:Young Adult
D003287:Contrast Media