Fibromuscular dysplasia of cardiac conduction system arteries in traumatic and nonnatural sudden death victims aged 0 to 40 years: a histological analysis of 100 cases

Cardiovasc Pathol. 2014 Jan-Feb;23(1):12-6. doi: 10.1016/j.carpath.2013.07.001. Epub 2013 Aug 19.

Abstract

Background: Since 1967, numerous case reports have described fibromuscular alterations of the sinus node artery and/or the atrioventricular node artery as a potential cause of death. However, the prevalence of these changes in a healthy population has only rarely been investigated systematically.

Methods: The arteries of the cardiac conduction system were studied systematically, by means of routine histology, in 100 cases of victims aged 0 to 40 years with a nonnatural cause of death.

Results: Microscopic alterations were seen in the walls of sinus node arteries in 52 out of 100 cases, in the walls of atrioventricular node arteries in 63/100 cases, and in the walls of small vessels in 60/100 cases.

Conclusions: The results demonstrate that microscopically detectable findings of the cardiac conduction system arteries similar to fibromuscular dysplasia do not indicate a defined disease and should not be considered as a cause of death when there are no macroscopic findings in the coronary arteries.

Keywords: Arteries; Cardiac conduction system; Fibromuscular dysplasia; Sudden cardiac death.

MeSH terms

  • Adolescent
  • Adult
  • Autopsy
  • Cause of Death
  • Cell Proliferation
  • Child
  • Child, Preschool
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / pathology*
  • Coronary Vessels / pathology*
  • Death, Sudden / pathology*
  • Female
  • Fibromuscular Dysplasia / mortality
  • Fibromuscular Dysplasia / pathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Severity of Illness Index
  • Wounds and Injuries / mortality
  • Wounds and Injuries / pathology*
  • Young Adult