Sudden Death of a Child due to Unidentified Chronic Myocarditis: Autopsy Findings

Objective – In this paper, we present the case of the sudden cardiac death of an apparently healthy 15-year-old adolescent, as well as the autopsy findings, with histopathology. Case report – A 15-year-old boy was found unconscious in his brother’s room. The boy had not been diagnosed with any disease and was apparently healthy. Preliminary autopsy findings indicated the predominance of cardiac pathology in relation to his death. All the cardiac cavities were dilated and enlarged. The trabeculae were more pronounced and thicker, with deepened spaces between them. In the anterior wall and almost the entire upper half of the posterior wall of the left ventricle, as well as the interventricular septum, with almost the entire thickness of the wall, the myocardial tissue was densely imbued with fibrous tissue. Microscopic analysis of cardiac sections showed large fields of hypocellular (scarring) fibrosis, as well as smaller fibrosis focuses of moderate cellularity, with fibroblasts, fibrocytes, and lymphocytes present. Toxicological analysis of blood taken from the femoral vein during autopsy was also performed, and the results showed that there were no traces of alcohol or psychoactive substances. Conclusion – Myocarditis is not uncommon in the pediatric population and has a relatively good prognosis, with most cases resulting in complete recovery. Extensive chronic inflammation with severe fibrosis in an apparently healthy boy leading to death makes our case particularly significant.