| Popis: |
In forensic pathology, genetic testing is a luxury that is not readily entertained. With molecular advances, genetic testing can provide critical information to conclude cause and manner of death in otherwise sudden, undetermined deaths. An autopsy was performed on a 30-year-old woman who died suddenly three months postpartum. The patient's history was unremarkable and included a negative electrocardiogram test prior to pregnancy. Toxicology results were negative and there were no gross or histologic findings on a complete postmortem examination including the conduction system. Prompted by personal interest and knowledge, the spouse, an electrophysiology fellow, requested genetic testing be performed and personally financed the tests. The results revealed two genetic mutations strongly associated with Type 1 Long QT Syndrome, expected to be familial. This provided a cause and manner of death and also instigated preventive measures for testing in the child. This case supports previous studies that acknowledge the need for molecular testing in the autopsy-negative, sudden unexpected death cases in young patients. Forensic pathologists have a duty to the public to serve as their physicians and this may prove to be a key area that can contribute to the preventative medicine effort and provide closure to families that may have loved ones left with an undetermined cause and manner of death. Although financially a problem, the future of pathology is undeniably heading in the direction of molecular testing and an attempt to adjust an internal budget in order to include expenses for these tests should be considered. |
