Cause of Sudden Cardiac Death may be Revealed Through Post-mortem MRI


Cardiac Death  Post-mortem MRI

Researchers have been able to identify chronic, subacute, acute and peracute MI using post-mortem cardiac MRI on human forensic bodies of patients who suffered sudden cardiac death. The imaging technique, they wrote, may present a promising alternative to clinical autopsy.

The researchers performed post-mortem MRIs with a 3-T system on the bodies of 136 patients who most likely died of cardiac causes prior to forensic autopsy. 

Post-mortem MRI identified at least one ischemic lesion in 76 of the 136 cases. The causes of death in these cases were ruled to be cardiac-related in the final forensic case ecaluation. In these patients, the researchers discovered 124 myocardial lesions, 25 of which were chronic, 16 subacute, 30 acute and 53 peracute. Verification of chronic, subacute and acute lesions could be made histologically and macroscopically, with 100% agreement between autopsy and post-mortem MRI findings.

However, the researchers were incapable to look at peracute lesions macroscopically on autopsy, but were able to verify peracute lesions discovered on post-mortem MRI scans in specified histological evaluations in 62.3% of cases. Peracute lesions could then be connected to a matching coronary finding in 84.9% of cases. The remaining 15.1% did not have a matching coronary finding but presented with severe myocardial hypertrophy or cocaine intoxication.

“Post-mortem imaging is a new tool to explore [sudden cardiac death]. As in popular television series, the careful collection and analysis of data from different sources, including clinical information and advanced post-mortem imaging, lead to the identification of the cause of death. From an epidemiological point of view, it will probably reduce the number of cases of unknown origin and may contribute to the establishment of a cost-effective diagnostic protocol,” wrote André Schmidt, MD, PhD, of the Medical School of Ribeirao Preto, University of São Paulo in Brazil, in an editorial.