Histopathological examination of the cardiac conduction system reveals age-related fatty infiltration and fibrosis, and is recommended for unexpected sudden death in the young rather than routine coronary artery disease autopsies.
Supports conduction system examination in young sudden deaths; leaves open routine use in coronary artery disease autopsies.
The histopathology of the cardiac conduction system was studied in 75 coroners' autopsies. Existing methods have been simplified and are described in detail. A minimum of three ***5 u sections need to be cut from each vena cavo atrial strip and each atrio ventricular block, for a successful result. Reasons for failure, difficulties in interpretation, and age-related changes in histopathological features are discussed. Fatty infilteration commences at 33 years old and fibrosis at 43 years old. Conduction system studies do not seem to increase the accuracy of routine autopsy diagnosis in deaths due to coronary artery disease. However, its study in unexpected sudden death in the young should be made compulsory. The difficulties in performing choline esterase tests on conduction systems are also highlighted.
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Niriellage Chandrasiri (1985) studied this question.
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