Korean J Leg Med.  2003 May;27(1):27-33.

Forensic Pathological Review of Acute Myocarditis

• Seo JS
• Lee SY
• Kim JH
• Jeon SH

Abstract

Cardiovascular disease is the most important cause of unexpected sudden death. Although ischemic heart disease by coronary atherosclerosis is the most common cause of sudden cardiac death, other diseases such as cardiomyopathy, congenital heart disease, valvular heart disease and rarely myocarditis can produce sudden cardiac death. Myocarditis is an inflammatory process of the myocardium characterized by an interstitial inflammatory infiltrate and an injury to myocytes adjacent to the inflammatory cells. The clinical expression of myocarditis ranges from the asymptomatic state to fulminant fatal congestive heart failure. Because myocardial involvement is subclinical in most acute infectious disease, the majority of patients have no specific complaints referable to the cardiovascular system. It is possible that it causes a medicolegal problems in case of sudden death. Therefore, author reviewed the clinical and pathological findings of 18 myocarditis autopsy cases. The victims 'age was varied 4-month-59-year olds. 5 (28%) were male and 13 (72%) were female. 15 cases received medical treatment due to clinical symptoms(URI symptoms: 2 cases, tonsillitis and tonsillar abcess: 3 cases, GI symptoms: 5 cases, URI & GI symptoms: 3 cases, pneumonia: 1 case, operation due to ovarian tumor: 1 case) and were associated with medicolegal problem. By the results of this study, important gross findings were pericardial effusions, characteristic cardiomegaly, and pulmonary edema.

Keyword

Myocarditis; Sudden Death; Medicolegal problem

MeSH Terms

Asymptomatic Diseases
Autopsy
Cardiomegaly
Cardiomyopathies
Cardiovascular Diseases
Cardiovascular System
Communicable Diseases
Coronary Artery Disease
Death, Sudden
Death, Sudden, Cardiac
Female
Heart Defects, Congenital
Heart Failure
Heart Valve Diseases
Humans
Male
Muscle Cells
Myocardial Ischemia
Myocarditis*
Myocardium
Palatine Tonsil
Pericardial Effusion
Pneumonia
Pulmonary Edema
Tonsillitis