Faiza Munir, Zoya Imran, Saima Manzoor, Urooj Husain, Imran Jawaad, Zobia Iqbal.
Autopsy on patients with atherosclerotic heart disease under medical perspective who are declared under sudden death.
J Allama Iqbal Med Coll Jan ;19(4):878-82.

Background: One of the leading causes of death in Pakistani population is atherosclerosis and coronary heart disease and is emerging as an epidemic which needs immediate action. The incidence of heart disease has increased many folds in the last couple of decades and if proper measures on emergency bases are not taken effectively it shall be the leading cause of death widening the gap between other causes of death. Methods: During medico legal autopsy those cases that had previous history of heart disease were elected at District Head Quarter Hospital Sheikhupura during a period of 06 months from 1st January to 30th June 2021. Only those cases that had previous history of heart disease and were using some medication were included in the study. All the three major coronary arteries were examined grossly, dissected and sectioned. Microscopic examination was carried out to rule out myocardial infarction, ischemic heart disease or atheroma. The criterion which was followed was based on American Heart Association for atherosclerotic plaque. All these steps were followed by medical department. Results: During the period of 06 months 57 cases were short listed to be included in the study. Atherosclerosis at various age groups which is observed in both sexes. Atheroma makes its appearance around the age of 20 years and becomes significantly prominent after 30 years and grossly is observed between 40 to 60 years. Coronary arteries showed calcification in 17.5% case, 13.9% had capillary defects. 22.8% cases showed gross atheroma ranging from luminal surface which have lipid core covered by intima which is normal to prominent calcification. 12% of these cases had a single vessel disease whereas 41.9% had two vessel diseases and 45% had triple vessel disease. Involvement of right coronary artery was 78.3%, left coronary artery in 81%, left anterior descending artery in 73% cases. The average age of patients who had myocardial infarction in this study is 51±12 years between 30 to 75 years. Conclusion: The study concludes that clinical complains of the patient are quite close to the expected finding in the coronary vessels as observed at the time of autopsy. It is further supported by the microscopic finding in the vessels. Key words: : Coronary artery, atherosclerosis, autopsy, myocardial infarction

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