正常冠状动脉心肌梗死(MINCA):健康军人死亡

Nadiawati Abdul Razak, F. Mohd Nor, Nur Najmi Mohamad Anuar, Ahmad Zakuan Kamarudin
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引用次数: 1

摘要

健康的军事人员突然意外死亡导致家属提出虚假指控。然而,大多数死亡与心脏异常有关。目的:猝死患者冠脉未闭的发生需要通过组织学检查和/或分子研究来发现潜在疾病,特别是在尸检计算机断层扫描(PMCT)或虚拟解剖技术有限的中心,这一点需要得到重视。本文报告了一例年轻健康男性工作人员在日常训练中死亡的病例。慢跑10分钟后,他晕倒了。为了确定死因,进行了尸检。尸检显示是一个中等身材的男性。没有发现致命的外部伤害。内部检查显示心脏肥大,冠状动脉未闭。心脏指标明显升高,毒理学分析正常。心脏组织学显示近期心肌梗死,故确定死因为正常冠状动脉心肌梗死。结论:强烈建议军人每年进行一次体检,以发现任何心脏异常。筛查可扩展到可疑和强烈家族史的遗传研究,以排除传导缺陷或通道病。
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Myocardial infarction in normal coronary artery (MINCA): Death in healthy military personnel
Sudden unexpected death among healthy military personnel leads to a false allegation from family members. However, majority of the deaths were related to an abnormal cardiac condition. Objective: The occurrence of patent coronary vessels in sudden deaths demands histological examination and/or molecular study to detect underlying diseases, which need to be highlighted especially in a centre with limitation of post-mortem computed tomography (PMCT) or virtopsy. In this article, a case of a young healthy male personnel, who died during routine training was reported. He collapsed after a 10-minute jog. An autopsy was performed to determine the cause of death. The autopsy showed a moderately built male. No fatal external injuries were found. Internal examination showed cardiomegaly and patent coronaries. The cardiac markers were markedly raised with normal toxicological analysis. Histology of the heart showed a recent myocardial infarct, hence the cause of death was determined as myocardial infarction in normal coronary artery (MINCA). Conclusion: Annual medical screening is highly recommended to detect any cardiac abnormalities among military personnel. Screening may be extended for a genetic study in suspicious and strong family history to exclude a conduction defect or channelopathy.
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