Sangita Moirangthem, Yadav Jayanthi, Chaurasia Jai Kumar, Arora Arneet, Jahan Afsar, Patnaik Mrinal
All India Institute Medical Sciences, Bhopal, Forensic Medicine and Toxicology, Bhopal, India.
All India Institute Medical Sciences, Bhopal, Pathology and Lab Medicine, Bhopal, India.
Autops Case Rep. 2023 Jul 19;13:e2023440. doi: 10.4322/acr.2023.440. eCollection 2023.
Hypoplastic coronary artery disease (HCAD) is a rare coronary artery anomaly that may be the cause of sudden death. It can involve a single or all coronary arteries. This anomaly may cause circulatory insufficiency leading to myocardial infarction. HCAD has no symptoms or may exhibit cardiovascular signs like syncope, dyspnea, chest discomfort, or dizziness. It is often diagnosed at autopsy, and early diagnosis is made with a coronary angiogram. We report HCAD as the cause of the sudden death of a 25-year-old female with a history of loss of consciousness following exertion. On autopsy, all the coronary arteries' lumen was narrowed with thin vessel walls. Histopathological examination shows an underdeveloped and missing muscular layer of the left anterior descending and circumflex coronary arteries' vascular wall. Many cases of HCAD diagnosed by radiographic imaging in living patients have been reported in the literature, but a structural anomaly of coronaries leading to HCAD has not been reported. We report a case of HCAD describing the histopathological examination findings of the vascular wall of coronary vessels illustrating the structural difference.
发育不全性冠状动脉疾病（HCAD）是一种罕见的冠状动脉异常，可能是猝死的原因。它可累及单支或所有冠状动脉。这种异常可能导致循环功能不全，进而引发心肌梗死。HCAD没有症状，或可能表现出如晕厥、呼吸困难、胸部不适或头晕等心血管体征。它常于尸检时被诊断出来，早期诊断则通过冠状动脉造影进行。我们报告一例HCAD导致一名25岁女性猝死，该女性有运动后意识丧失史。尸检时，所有冠状动脉管腔变窄，血管壁变薄。组织病理学检查显示左前降支和回旋支冠状动脉血管壁的肌层发育不全且缺失。文献中已报道了许多通过影像学检查在活体患者中诊断出的HCAD病例，但尚未有导致HCAD的冠状动脉结构异常的报道。我们报告一例HCAD病例，描述了冠状动脉血管壁的组织病理学检查结果，阐明了结构差异。
