Sudden Death without a Clear Cause after Comprehensive Investigation: An Example of Forensic Approach to Atypical/Uncertain Findings

Autor: Simone Grassi, Mònica Coll Vidal, Oscar Campuzano, Vincenzo Arena, Alessandro Alfonsetti, Sabina Strano Rossi, Francesca Scarnicci, Anna Iglesias, Ramon Brugada, Antonio Oliva
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Diagnostics, Vol 11, Iss 5, p 886 (2021)
Druh dokumentu: article
ISSN: 2075-4418
DOI: 10.3390/diagnostics11050886
Popis: Sudden death (SD) is defined as the unexpected natural death occurred within an hour after the onset of symptoms or from the last moment the subject has been seen in a healthy condition. Brugada syndrome (BrS) is one of the most remarkable cardiac causes of SD among young people. We report the case of a 20-year-old man who suddenly died after reportedly having smoked cannabis. Autopsy, toxicology, and genetic testing were performed. Autopsy found a long and thick myocardial bridging (MB) at 2 cm from the beginning of the left anterior descending coronary artery. Furthermore, at the histopathological examination, fibrosis and disarray in myocardial area above the MB, fatty tissue in the right ventricle and fibrosis of the sino-atrial node area were found. Toxicology testing was inconclusive, while genetic testing found a rare missense variant of the TTN gene, classified as likely benign, and a variant of unknown significance in the SLMAP gene (a gene that can be associated with BrS). Hence, despite several atypical features were found, no inference on the cause of the death could be made under current evidence.
Databáze: Directory of Open Access Journals