A 42-year-old male who survived 48 hours after an out-of-hospital cardiac arrest exhibited rapid and extensive dystrophic intramyocyte microcalcification in areas of subendocardial infarction.
Case Report (n=1)
No
Rapid dystrophic intramyocyte microcalcification can occur as a rare histological manifestation of severe global myocardial ischemia following cardiac arrest and resuscitation within 48 hours.
Abstract Background Early myocardial calcification is an uncommon histopathological finding and is usually associated with chronic myocardial injury. Rapid intramyocyte microcalcification following global ischemia is rarely described. Case presentation A 42-year-old previously healthy male suffered an out-of-hospital cardiac arrest while cycling. Following prolonged cardiopulmonary resuscitation and return of spontaneous circulation, he was admitted to ITU before being confirmed to have Hypoxic Ischemic Encephalopathy not compatible with life. Despite intensive supportive management for multiorgan failure patient was pronounced dead within 48 h of admission. There was no family history of heart disease or sudden cardiac death. The comprehensive forensic autopsy examination revealed no significant traumatic injuries that could account for death. Specialized cardiac examination showed subendocardial haemorrhagic infarction over the left ventricle. Histological examination demonstrated extensive focal intramyocyte microcalcification affecting sub endocardium of both ventricles in the areas of infarction with absence of fibrosis or inflammation. Conclusion This case highlights rapid dystrophic intramyocyte microcalcification as a rare histological manifestation of severe global myocardial ischemia following cardiac arrest and resuscitation. Autopsy pathologists should be aware that subendocardial infarction with or without intramyocyte microcalcification and HIE occur secondary to cardiac arrest in those admitted to ITU and it is essential to investigate the cause of the primary cardiac arrest.
Jayarathna et al. (Mon,) conducted a case report in Out-of-hospital cardiac arrest (n=1). Cardiopulmonary resuscitation and intensive care was evaluated on Histopathological findings at autopsy. A 42-year-old male who survived 48 hours after an out-of-hospital cardiac arrest exhibited rapid and extensive dystrophic intramyocyte microcalcification in areas of subendocardial infarction.