Serinelli Serenella, Gitto Lorenzo, Stoppacher Robert
Department of Pathology, State University of New York, Upstate Medical University, Syracuse, NY.
J Forensic Sci. 2019 Nov;64(6):1916-1920. doi: 10.1111/1556-4029.14076. Epub 2019 May 31.
Atrial septal defects (ASDs) are one of the most prevalent congenital cardiac anomalies in adults. These interatrial communications can produce changes in the right heart (remodeling and failure) and the lungs (pulmonary hypertension). Most adults with ASDs are surgically treated with excellent results. However, a small fraction of patients is at risk for postoperative complications, particularly the persistence of pulmonary hypertension. A case of a 47-year-old woman who was found unresponsive in the bathroom of her house and died despite resuscitative efforts is described. According to medical records, the woman underwent a surgical repair of an atrial septal defect at the age of 37. At the autopsy, macroscopic and microscopic signs of advanced pulmonary hypertension were detected, highlighting the importance for the forensic pathologists to recognize pulmonary hypertension as a cause of sudden death in adults with a history of late surgical closure of an atrial septal defect.
房间隔缺损（ASD）是成人中最常见的先天性心脏异常之一。这些心房间交通可导致右心（重塑和衰竭）及肺部（肺动脉高压）发生改变。大多数患有房间隔缺损的成年人接受手术治疗后效果良好。然而，一小部分患者有术后并发症的风险，尤其是肺动脉高压持续存在。本文描述了一名47岁女性的病例，她在家中浴室被发现无反应，尽管进行了复苏努力仍不幸死亡。根据病历记录，该女性37岁时接受了房间隔缺损的手术修复。尸检时，检测到了晚期肺动脉高压的宏观和微观征象，这凸显了法医病理学家认识到肺动脉高压是有房间隔缺损晚期手术闭合病史的成年人猝死原因的重要性。
