Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy.
University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Virchows Arch. 2021 Jul;479(1):79-94. doi: 10.1007/s00428-021-03038-0. Epub 2021 Mar 19.
Since cardiac hypertrophy may be considered a cause of death at autopsy, its assessment requires a uniform approach. Common terminology and methodology to measure the heart weight, size, and thickness as well as a systematic use of cut off values for normality by age, gender, and body weight and height are needed. For these reasons, recommendations have been written on behalf of the Association for European Cardiovascular Pathology. The diagnostic work up implies the search for pressure and volume overload conditions, compensatory hypertrophy, storage and infiltrative disorders, and cardiomyopathies. Although some gross morphologic features can point to a specific diagnosis, systematic histologic analysis, followed by possible immunostaining and transmission electron microscopy, is essential for a final diagnosis. If the autopsy is carried out in a general or forensic pathology service without expertise in cardiovascular pathology, the entire heart (or pictures) together with mapped histologic slides should be sent for a second opinion to a pathologist with such an expertise. Indication for postmortem genetic testing should be integrated into the multidisciplinary management of sudden cardiac death.
由于心脏肥大在尸检时可能被视为死亡原因，因此需要采用统一的评估方法。需要使用通用术语和方法来测量心脏重量、大小和厚度，并根据年龄、性别、体重和身高系统地使用正常值的截断值。出于这些原因，代表欧洲心血管病理学协会编写了相关建议。诊断工作包括寻找压力和容量超负荷的情况、代偿性肥大、储存和浸润性疾病以及心肌病。虽然一些大体形态特征可以指向特定的诊断，但系统的组织学分析，随后可能的免疫染色和透射电子显微镜检查，对于最终诊断至关重要。如果尸检是在没有心血管病理学专业知识的普通或法医病理学服务机构进行的，则应将整个心脏（或图片）连同映射的组织学切片一起发送给具有该专业知识的病理学家进行二次诊断。应将死后基因检测的适应证纳入心脏性猝死的多学科管理中。
