al-Alousi L M
Pathology Department, Hairmyres Hospital, East Kilbride, Glasgow.
Med Sci Law. 1990 Jan;30(1):67-87. doi: 10.1177/002580249003000115.
The medicolegal importance of ischaemic heart disease and myocardial infarction is summarized and discussed. Some theories of pathogenesis and aetiology of ischaemic heart disease, specially those which are more important and relevant to the medicolegal practice, are discussed. Results of the study of 33 cases of coronary artery atherosclerosis and myocardial infarction at different stages of development are presented. The condition of the coronary arteries and the myocardium is examined on gross and microscopical levels. Pathological findings are correlated with the clinical data obtained from the case histories and the summaries of the necropsy requests. No good correlation exists between the observed pathological changes and the clinical age of the infarction and, in most instances, the latter appears younger than the age estimated on the pathological ground alone. As far as the age of the infarction is concerned, most special histochemical staining methods are not preferable to the routine haematoxylin and eosin method. However, the former are efficient in demonstrating and confirming certain aspects of the infarction which cannot be ascertained by the latter method of staining. Pathological alterations associated with myocardial infarction at successive ages are explained and various methods of estimating the time of the infarction are discussed. Thus, gross and microscopical appearances of the acute, organizing and healed myocardial infarction are illustrated by photographs and the forensic applications of these morphological changes are discussed. Lastly, a rare case of an acute myocardial infarction associated with a heat stroke is presented and the medicolegal problems resulting from this case are discussed.
本文总结并讨论了缺血性心脏病和心肌梗死的法医学重要性。探讨了缺血性心脏病发病机制和病因的一些理论，特别是那些对法医学实践更为重要且相关的理论。介绍了33例处于不同发展阶段的冠状动脉粥样硬化和心肌梗死的研究结果。从大体和显微镜水平检查冠状动脉和心肌的状况。病理结果与从病史和尸检申请摘要中获得的临床数据相关联。观察到的病理变化与梗死的临床年龄之间没有良好的相关性，并且在大多数情况下，后者看起来比仅基于病理依据估计的年龄要小。就梗死年龄而言，大多数特殊组织化学染色方法并不比常规苏木精和伊红方法更可取。然而，前者在证明和确认梗死的某些方面是有效的，而这些方面是后者染色方法无法确定的。解释了不同年龄段与心肌梗死相关的病理改变，并讨论了估计梗死时间的各种方法。因此，通过照片展示了急性、机化和愈合心肌梗死的大体和显微镜表现，并讨论了这些形态学变化的法医应用。最后，介绍了一例罕见的与中暑相关的急性心肌梗死病例，并讨论了该病例引发的法医学问题。
