Strangulation of the heart presenting as sudden cardiac death: A deadly but forgotten complication of epicardial pacing device.
Leg Med (Tokyo)
; 32: 107-112, 2018 May.
Article
en En
| MEDLINE
| ID: mdl-29655034
ABSTRACT
Strangulation of the heart appears to be an exceedingly rare mechanical phenomenon that can develop with epicardial pacing wires in individuals undergoing somatic growth. Over the passage of time, owing to size mismatch between a fixed wire length and dynamically growing heart, the epicardial wire may embed around the heart resulting in the progressive over-pressurizing of involved cardiac structures. Depending on the location of the peak constriction pressures, cardiac strangulation may damagingly affect coronary circulation, heart valves function, or physiologic filling of the heart chambers, with risk of myocardial ischemia, decreased cardiac output, acute cardiac failure, ventricular arrhythmias and death. We report a case of a 29-year-old male with sudden cardiac death owing to cardiac strangulation with epicardial pacing wire that had been retained in place almost 30â¯years. At autopsy, an enlarged and abnormally contoured heart was found to be strangulated by an epicardial pacing wire; histopathologic examination confirmed hypertrophy of the myocardial fibers, myofiber disarrangement, and replacement-type fibrolipomatosis. In addition, this article consolidates the available literature on cardiac strangulation by an epicardial wire and highlight relevant clinical and medico-legal features for the forensic professionals.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arritmias Cardíacas
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Muerte Súbita Cardíaca
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Dispositivos de Terapia de Resincronización Cardíaca
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
Leg Med (Tokyo)
Asunto de la revista:
JURISPRUDENCIA
Año:
2018
Tipo del documento:
Article