Swalwell C I, Reddy S K, Rao V J
Office of the Medical Examiner, San Diego, CA 92123.
Am J Forensic Med Pathol. 1991 Dec;12(4):306-12. doi: 10.1097/00000433-199112000-00007.
Coronary artery vasculitis is a well-recognized complication of polyarteritis nodosa and is occasionally seen in other forms of systemic vasculitis. However, involvement of the major epicardial coronary arteries leading to myocardial infarction and death is uncommon. Isolated coronary arteritis is even more rare. We report three cases of sudden death due to myocardial ischemia associated with arteritis of the major coronary arteries. All three decedents were previously healthy young to middle-aged men who had died suddenly after complaints of chest pain and shortness of breath. The autopsy findings and differential diagnoses are presented. Such cases are of particular interest to the medical examiner because of the sudden, unexpected nature of the deaths. An approach to the correct diagnosis is discussed.
冠状动脉血管炎是结节性多动脉炎一种公认的并发症，偶尔也可见于其他形式的系统性血管炎。然而，主要的心外膜冠状动脉受累导致心肌梗死和死亡的情况并不常见。孤立性冠状动脉炎更为罕见。我们报告了3例因主要冠状动脉炎伴心肌缺血导致猝死的病例。所有3例死者均为先前健康的中青年男性，在出现胸痛和呼吸急促症状后突然死亡。文中展示了尸检结果及鉴别诊断。由于这些死亡具有突然性和意外性，法医对这类病例尤为关注。本文还讨论了正确诊断的方法。
