Gabarrou Gabrielle, Guilbeau-Frugier Céline, Blanc Anthony, Telmon Norbert, Savall Frederic
Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse, 31059, France.
J Forensic Sci. 2018 Mar;63(2):611-613. doi: 10.1111/1556-4029.13561. Epub 2017 Jul 10.
We report the case of a middle-aged man, without medical history, who suddenly died at his workplace. The autopsy highlighted a pathological heart macroscopically, with multiple small white areas on the left myocardium. Coronary dissection revealed a pseudotumoural fibromyxoid aspect within the anterior interventricular artery (AIVA) and the left main coronary trunk, including reduction in their diameter with tight stenosis. Microscopic examination of these arteries showed fibroinflammatory wall destruction. In the left myocardium, there were multiple focal ischemic areas at different stages of recovery. Our case is an illustration of primary ischemic heart disease due to coronary arteritis, with a pseudotumoural presentation, which was revealed by sudden death. We discuss the cause of death and the etiological diagnosis preceding coronary arteritis.
我们报告一例中年男性病例，该患者无病史，在工作场所突然死亡。尸检在宏观上突出显示心脏存在病变，左心肌有多个小白斑区域。冠状动脉解剖显示前室间动脉（AIVA）和左冠状动脉主干内有假瘤样纤维黏液样外观，包括其直径减小并伴有严重狭窄。对这些动脉的显微镜检查显示纤维炎性壁破坏。在左心肌中，有多个处于不同恢复阶段的局灶性缺血区域。我们的病例是由冠状动脉炎导致的原发性缺血性心脏病的一个例证，其呈现假瘤样表现，因猝死而得以揭示。我们讨论了死因以及冠状动脉炎之前的病因诊断。
