Lesions of the Cardiac Conduction System and Sudden Death.

When a young previously healthy person dies suddenly, occasionally, the scene is noncontributory and the autopsy and drug screen are negative. In such cases, additional studies, including genetic assessment and cardiac conduction system examination, should be performed. We performed a literature search and reviewed our own material to identify possible or definite conduction system anomalies that may cause death.

Fatal visceral larva migrans from Toxocara catis infection of the heart and liver in a child.

We discuss the pathophysiology and epidemiology of Toxocara catis infection complicated by visceral larval migrans . We describe a previously healthy 19-month-old white male child found dead in bed by his mother. He had what was thought to be an upper respiratory infection for several days.

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly.

A 40-year-old woman presented with recurrent syncope. She reported multiple (>20) episodes of non-prodromal loss of consciousness, periodically provoked by physical exertion. One episode resulted in a nasal fracture due to the abrupt nature of her syncope.

Fatal rupture of pseudoaneurysm following angioplasty.

We report the sudden unexpected death from exsanguination of a 60-year-old white female who underwent balloon angioplasty of her right popliteal artery via a right common femoral arteriotomy 3 weeks before death. This resulted in a mycotic pseudoaneurysm of the right femoral artery that ruptured, causing fatal exsanguination. A pseudoaneurysm is an arterial wall defect in which part of the wall consists of fibrin and fibrous tissue, lacking components of the normal arterial wall, that is intima, media, and adventitia.

Cystic tumour of the atrioventricular node: case report and literature review.

Cystic tumour of the atrioventricular node is the smallest tumour that can cause sudden cardiac death. This lesion arises from foregut endodermal rests which become enfolded into the heart during embryogenesis. Typically causing heart block, the tumour can cause sudden death despite pacemaker placement.

Fatal Intestinal Obstruction in a Patient With Fetal Alcohol Syndrome.

We describe an 8-year-old white boy with a history of fetal alcohol syndrome and pica, who was found dead on the floor by his mother. The child died from massive intestinal dilatation causing asphyxia. We discuss the potential pathogenetic mechanisms of intestinal dilation in patients with fetal alcohol syndrome.

The danger zone: Injuries and conditions associated with immediately fatal motorcycle crashes in the state of Michigan.

Background: Immediately fatal motorcycle crashes have not been well characterized. This study catalogues injuries sustained in fatal motorcycle crashes and assesses the impact of crash conditions on injury patterns.

Methods: Autopsy records from the office of the medical examiner of Kent County, MI and publicly available traffic reports were queried for information pertaining to motorcyclists declared dead on-scene between January 1, 2007, and December 31, 2016.

Fatal Airway Obstruction in a Man With a Cystic Hygroma.

We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him.

Primary Cardiac Fibroma in an Adult.

Cardiac fibromas are benign primary tumors composed of connective tissue and fibroblasts. These uncommon tumors are primarily found in the pediatric population, and their prevalence among the adult population is exceedingly rare. We report a case of an adult with nonspecific symptoms, who was subsequently found to have a solitary mass located in the left ventricle.

A case of sudden cardiac death due to eosinophilic coronary periarteritis: possible significance of coexisting atherosclerosis and eosinophilic inflammation of the esophagus.

Background: Eosinophilic coronary periarteritis (ECPA) is a rare disease found in cases of sudden cardiac death due to coronary vasospasm or spontaneous coronary artery dissection. Currently, the etiology, pathogenesis, and pathophysiology of ECPA are unknown. Cases of ECPA with a history of allergic disorders are rare.

Self-administered ethanol enema causing accidental death.

Excessive ethanol consumption is a leading preventable cause of death in the United States. Much of the harm from ethanol comes from those who engage in excessive or hazardous drinking. Rectal absorption of ethanol bypasses the first pass metabolic effect, allowing for a higher concentration of blood ethanol to occur for a given volume of solution and, consequently, greater potential for central nervous system depression.

Fatal coronary artery intimal hyperplasia due to amphetamine use.

Background: Amphetamines have been reported to cause myocardial infarct, cerebral hemorrhage, aortic dissection, hypertension, vasculitis, aneurysms, and, occasionally, death from direct toxicity. To date, there have been no reports of coronary intimal hyperplasia in an amphetamine user.

Methods: A 29-year-old male was found collapsed after jogging.

Incidence of pulmonary fat embolism at autopsy: an undiagnosed epidemic.

Background: To determine the incidence, time course, and severity of pulmonary fat embolism (PFE) and cerebral fat embolism (CFE) in trauma and nontrauma patients at the time of autopsy.

Methods: Prospectively, consecutive patients presenting for autopsy were evaluated for evidence pulmonary and brain fat embolism. The lung sections were obtained from the upper and lower lobe of the patients' lungs on the right and left and brain tissue.

Cerebral fat embolism without intracardiac shunt: A novel presentation.

Fat embolism syndrome (FES) is defined as an uncommon life-threatening disease process consisting of pulmonary, central nervous system (CNS), and cutaneous manifestations. The pathophysiology of this secondary injury is poorly understood. In the setting of the multiply injured patient, the diagnosis of FES is difficult to ascertain.

Early catastrophic stentless valve failure secondary to possible immune reaction.

Aortic valve replacement with stentless xenografts has become routine since their introduction in the early 1990s. Although concerns of structural valve deterioration and long-term durability have been voiced, the reports on the causes or pathology associated with early valve failure have been sparse. We report two unusual cases of failure leading to patient death within the first year after implantation of the aortic valve and root with the Freestyle prostheses (Medtronic Inc, Minneapolis, MN).

Circumflex artery from the right coronary sinus: a not-so-benign anomaly.

The origin of the circumflex coronary artery from the right sinus of Valsalva is generally considered a benign anomaly. Herein we report the sudden unexpected death of a 6-year-old boy who died after jumping into a swimming pool and whose only pathologic finding was this usually inconsequential coronary artery anomaly. A discussion of the pathophysiology of the disorder and a literature review are included.

Fifteen-year retrospective study of infant organ weights and revision of standard weight tables.

No recent studies of organ weights of normal infants exist. We completed a 15-year retrospective study of organ weights of normal infants who died between 1986 and 2000 in an effort to update the "normal" weight standards for infants up to one year of age. Additionally, we compared organ weights of infants whose deaths were ruled Sudden Infant Death Syndrome (SIDS) with those of other natural or non-natural causes within the same age groups, length and total body weight at autopsy, total organ weight as a percentage of total body weight, and with weight standards based on previous studies.

Fatal hemoptysis from Behcet's disease in a child.

Objective: To present a case of pulmonary artery aneurysms (PAAs) in a child with Behcet's disease (BD). NATURE OF THE STUDY: Case report and review of the literature.

Materials And Methods: The patient had a complete autopsy, drug screen and serological testing.

Deaths associated with liposuction: case reports and review of the literature.

Tumescent liposuction is a common cosmetic procedure that is performed as an outpatient service in physician's offices and is largely believed to be safe. The protuberant areas of the body containing the undesirable fat deposits are injected with normal saline containing lidocaine and epinephrine for pain control and hemostasis, and the waterlogged cells are suctioned out via cannula through a small incision. We recently encountered three cases in which deaths were attributed to this procedure.