Lynch Matthew J, Woodford Noel W F, Dodd Malcolm J
Department of Forensic Medicine, Monash University, Victorian Institute of Forensic Medicine, Southbank Victoria, Monash, Australia.
J Forensic Leg Med. 2008 Oct;15(7):443-6. doi: 10.1016/j.jflm.2007.12.012. Epub 2008 Jul 9.
Coarctation of the aorta is one of the more common congenital cardiac defects accounting for between 5 and 10% of cases of congenital heart disease. It has traditionally been divided into infantile (pre-ductal) and adult (ductal) types. Prior to the development of surgical treatment for coarctation, the condition was associated with significant morbidity and mortality with the most common causes of death being aortic rupture, congestive cardiac failure, endocarditis and intracerebral haemorrhage. Presentation of undiagnosed aortic coarctation as sudden and unexpected death is today a distinctly uncommon phenomenon. We report one such case, that of an adolescent male who at autopsy was noted to have coarctation of ductal type with aortic dissection and haemopericardium. The presence of this condition should be considered by the forensic pathologist confronted with aortic dissection, particularly in a young person.
主动脉缩窄是较常见的先天性心脏缺陷之一,占先天性心脏病病例的5%至10%。传统上它被分为婴儿型(导管前型)和成人型(导管后型)。在主动脉缩窄的外科治疗发展之前,这种疾病与显著的发病率和死亡率相关,最常见的死亡原因是主动脉破裂、充血性心力衰竭、心内膜炎和脑出血。如今,未被诊断的主动脉缩窄表现为突然意外死亡是一种明显不常见的现象。我们报告了这样一例病例,一名青少年男性,尸检时发现为导管后型主动脉缩窄并伴有主动脉夹层和心包积血。面对主动脉夹层的法医病理学家,尤其是面对年轻人时,应考虑到这种情况的存在。