Diagnosis of early myocardial infarction by histochemical staining of heart on autopsy table
Journal Title: Medpulse International Journal of Forensic Medicine - Year 2019, Vol 10, Issue 3
Abstract
Background: Determination of cause of death is the main objective in every Medico-Legal Autopsy. Most often, the identification of early change of Myocardial infarction becomes difficult during postmortem examination, as a gross change of infarct will not be apparent for 24 to 48 hours following myocardial ischemic damage. "Identification of the earliest Stage of myocardial ischemia remains a pressing challenge. Aim: To determine the diagnostic validity of the Histochemical Staining (TTC) of heart in gross detection of early Myocardial Infarction. Materials and Methods: The Present Study Was Conducted In 2018 The Institute of Forensic Medicine Government Mohan Kumaramangalam Medical College Hospital, Salem The Study Sample Consists of 18 Hearts Taken From Cases Of Sudden Deaths With Either History Or The Morphological Features Of Heart Suggestive Or Suspected The Cause Of Death To Be Of Cardiac Origin. Results: Males occupy a predominant number of cases, accounts for about 94.4% of the sample, whereas female constitute only 5.61% of the sample. It signifies the incidence of myocardial infarction / sudden cardiac deaths is greater among males. Out of 18 hearts stained using 1% Triphenyl Tetrazolium Chloride solution, 6 hearts with no apparent gross change showed areas of unstaining were considered TTC positive for early myocardial, Histopathological examination of the 6 TTC positive hearts showed features of early myocardial infarction in 5 hearts, One TTC positive for early infarction heart showed features of normal myocardium i.e. Considered as false TTC positive.5 hearts showed areas of old infarct, one heart showed area of old infarct and area of hyperemia with softening on gross examination. TTC staining of these 6 hearts showed the area of unstaining in addition to the area of unstaining due old infarct (which is evident on gross examination) and was considered TTC positive for early myocardial infarction and old infarction. Histopathological examination of the 6 TTC positive hearts showed features of both early myocardial infarction and features of old infarction. Conclusions: The present study concludes that Histochemical staining of the heart using Triphenyl Tetrazolium Chloride is a reliable method in the detection of early myocardial infarction for Forensic pathologist during postmortem examination, as the method in the present study, has got the diagnostic validity of 88.8%.
Authors and Affiliations
M Sivanandam
Keywords
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- EP ID EP614889
- DOI 10.26611/10181031
- Views 184
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