Key result
Sudden death autopsy reveals small VSD with membranous septum aneurysm and fibrous RBB interruption.
Case Report (n=1)
This case suggests that hereditary right bundle branch block, rather than an aneurysm of the membranous septum, may be responsible for unexpected sudden death in patients with small VSDs.
Answers are grounded in this paper and cite their sources.
May prompt conduction evaluation in small VSD with RBBB; hypothesis-generating, needs larger confirmation.
An apparently healthy man of 26 years of age suddenly died. He was known to have had a small ventricular septal defect and complete right bundle branch block from early childhood. At post-mortem examination the small ventricular septal defect was found associated with an aneurysm of the membranous septum. Histological examination showed a normal atrioventricular node and bundle, adjacent to the aneurysm. There was fibrous interruption at the commencement of the right bundle branch, which was considered the basis of the bundle branch block. It was also considered that the right bundle branch block was of the hereditary type and that this, rather than the aneurysm of the membranous septum, was responsible for the unexpected death.
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Sarubbi et al. (1999) conducted a case report in Sudden death, small ventricular septal defect, complete right bundle branch block (n=1). Hereditary right bundle branch block was evaluated on Post-mortem findings. Post-mortem examination of a 26-year-old man with sudden death revealed a small ventricular septal defect with an aneurysm of the membranous septum and fibrous interruption of the right bundle branch.
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