Post mortem, study of heart in cases of sudden cardiac death using acridine orange fluorescence and haematoxylin and eosin stain

AbstractBackground: Myocardial infarction is the most common cause of death for which the largest numbers of autopsiesare done. Aim: A clinical study was done to determine those numerically smaller but medico-legally more important cases in which some unnatural event like a road accident, is suspected to have been precipitated by acute myocardial ischemia. The likelihood of identifying an early infarct depends on the mechanism of the terminal cardiac failure. Materials and method: A histochemical study on early ischemic changes in 100 hearts which can detect the healthy as well as the infarcted myocardium due to enzymatic changes in the myocardium, using haematoxylin and eosin as a routine stain and acridine orange as a fluorescent stain, the latter can detect infarcts of even 2 hours of age to assess the actual age of the infarct and confirmation of myocardial infarction as the cause of demise was done. Results: 37% of the cases were seen in the 6 th decade followed by 4 th & 5 decade, males were more affected, the male to female ratio being 11.5:1. 75% of the cases showed grade 2 and grade 3 stenosis of coronary artery. Majority of the hearts were within normal weight range showing absence of chronicity of disease. Conclusion: Sudden death due to myocardial infarction is still the disease of middle age with increasing incidence in younger age groups, acridine orange is the earliest detector of infarction and degree of stenosis is directly related with the age factor most common cause for that being atherosclerosis. Keywords: Acridine orange, Early infarct, Fluorescent microscopy.