Department of Forensic Medicine and Toxicology, Ganapathichettikulam Village No. 20, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, 605014, India.
Department of Anatomy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Manipal, Karnataka, 576104, India.
F1000Res. 2024 Sep 12;13:1050. doi: 10.12688/f1000research.152421.1. eCollection 2024.
Sudden and unexpected deaths are increasing drastically. The main cause of sudden death is cardiovascular disease, out of which coronary artery disease predominates forming 80% of the cases. Most of the time, detecting early changes in myocardial infarction during the autopsy is challenging since gross infarct changes do not appear until after 24 to 48 hours of myocardial ischemia injury. So, the aim of this study was to compare two test to detect early changes of Myocardial Infarction one by using Triphenyl Tetrazolium Chloride (TTC) staining of the myocardial tissue, during autopsy and other by histopathological examination.
The sample size of 60 hearts taken from all the sudden deaths cases brought to Mortuary with suspected cause of death due to cardiac origin. The heart was obtained from the deceased by standard post-mortem technique. Serial full-thickness transverse sections of the heart were taken at 2 cm intervals from the apex to the atrioventricular groove. All the serial slices of heart are taken for histochemical staining and TTC staining.
In histopathological examination 34 hearts were diagnosed with myocardial infarction and 26 hearts reported non myocardial infarction. With TTC 40 hearts remained unstained suggestive of myocardial infarction and 20 hearts were stained suggestive of non-infarcted hearts. TTC staining in our study shows an accuracy of 88.33%.
The result of this study shows that the Triphenyl Tetrazolium Chloride test, a histochemical staining technique of heart, is reliable approach for forensic pathologists to diagnose early myocardial infarction during the post-mortem examination.
猝死的发生率正在急剧上升。猝死的主要原因是心血管疾病，其中冠状动脉疾病占主导地位，占病例的 80%。大多数情况下，在尸检中早期发现心肌梗死的变化具有挑战性，因为在心肌缺血损伤 24 至 48 小时后才会出现明显的梗死变化。因此，本研究旨在比较两种检测方法，一种是通过心肌组织三苯基四唑氯（TTC）染色，另一种是通过组织病理学检查，来检测心肌梗死的早期变化。
从所有因心脏原因疑似死亡而被带到太平间的猝死病例中抽取了 60 个心脏作为样本。心脏是通过标准的尸检技术从死者身上获得的。从心尖到房室沟以 2cm 的间隔取心脏的全层横向连续切片。对所有心脏切片进行组织化学染色和 TTC 染色。
在组织病理学检查中，34 个心脏被诊断为心肌梗死，26 个心脏被报告为非心肌梗死。在 TTC 染色中，40 个心脏未染色提示心肌梗死，20 个心脏染色提示非梗死心脏。TTC 染色在本研究中的准确率为 88.33%。
本研究结果表明，三苯基四唑氯试验（一种心脏的组织化学染色技术）是法医病理学家在尸检中诊断早期心肌梗死的可靠方法。
