Crudele Graziano Domenico Luigi, Amadasi Alberto, Marasciuolo Laura, Rancati Alessandra, Gentile Guendalina, Zoja Riccardo
Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
Leg Med (Tokyo). 2016 Mar;19:1-4. doi: 10.1016/j.legalmed.2016.01.005. Epub 2016 Jan 13.
The inflammatory involvement of vital organs may represent a dangerous and life-threatening situation: in particular, the inflammation of the myocardial tissue of the heart may lead to severe consequences since the clinical history of the disease may be completely asymptomatic, any clinical sign may be lacking, thus preventing correct diagnosis and treatment. This may occur even in the case of myocarditis and may lead to unexpected death whose cause can be assessable only by means of a thorough histopathological examination. The article reports the case of 61-year old female who developed a flu-like syndrome with very few symptoms, followed by sudden death in three weeks. The autopsy and following histopathological investigations identified the cause of death in a post-viral lymphocytic myocarditis, probably related to the previous infectious disease, and alternative causes (as arrhythmic ventricular dysplasia, vasculitis, sarcoidosis and giant cell myocarditis) were excluded. The exclusive location in the right ventricle was a peculiar finding. The case highlights the importance of the myocardium of the right ventricle, a tissue which is often less considered even in histopathological surveys. The exclusive location of myocarditis in the right ventricle is a rare event but in this case fully responsible for death.
特别是心脏心肌组织的炎症可能导致严重后果，因为该疾病的临床病史可能完全没有症状，可能缺乏任何临床体征，从而妨碍正确的诊断和治疗。这甚至可能发生在心肌炎的情况下，并可能导致意外死亡，其原因只能通过全面的组织病理学检查来评估。本文报道了一名61岁女性的病例，她出现了症状极少的类似流感综合征，三周后突然死亡。尸检及随后的组织病理学调查确定死亡原因是病毒性淋巴细胞性心肌炎，可能与先前的传染病有关，并排除了其他原因（如心律失常性心室发育异常、血管炎、结节病和巨细胞心肌炎）。仅累及右心室是一个特殊发现。该病例凸显了右心室心肌的重要性，即使在组织病理学检查中，该组织也常常较少受到关注。心肌炎仅局限于右心室是一种罕见情况，但在本例中却是导致死亡的完全原因。
