Significance of microcirculatory disturbance of basilar ventricular septum in cases of sudden cardiac death

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1. Author examined 60 heart of sudden cardiac death and compared with 20 normal hearts. Possible significant decreasing of small arteries and endothelial cells were found in basilar ventricular septum in some cases of sudden cardiac death. This results showed localized ischemia in basilar ventricular septum due to relative decreasing of small arteries and capillaries in basilar may be one of the causes of sudden cardiac death.2. The cardiac conduction system of 80 hearts without gross injury from patients who had received cardiopulmonary resuscitation (CPR) due to non-traumatic causes was examined. Of these 80 cases, localized hemorrhage and injury without inflammatory reaction was evident in 7 of these cases. It can be presumed that injuries to the conduction system do occur in limited regions during CPR.3. We present two extremely rare autopsy cases with atresia of the left coronary ostium. Case 1 was a 34-year-old man who died of sudden cardiac death and Case 2 was an 82-year-old woman who died from non-cardiac causes. In both cases, a string-like small left main trunk that was located in its normal position was found, however the orifice of the left coronary artery was absent. The caliber and/or other anatomical features of the Collateral artery may predominantly dictate the clinical course of patients with atresia of the left coronary ostium.4. We report a case of sudden unexpected death in a 17-year-old male student showing similar clinical background and pathological findings to Reye's syndrome. His heart showed some cardiac abnormal findings and did not showed any findings of Reye's syndrome. The present case would seem to suggest that a postmortem diagnosis of RS should be determined very carefully in cases of sudden death, even if the general circumstances would seem to be consistent with RS.