Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1992 Mar;45(3):217–220. doi: 10.1136/jcp.45.3.217

Necropsy study of association between sudden death and cardiac enzymes.

J Burns 1, C M Milroy 1, B Hulewicz 1, C R West 1, S M Walkley 1, N B Roberts 1
PMCID: PMC495475  PMID: 1556228

Abstract

AIMS: To determine if cardiac enzymes measured at necropsy could be used to predict early myocardial infarction. METHODS: Cardiac enzyme activities were measured in body fluids at necropsy. Coroners' necropsies were grouped by gross and microscopic findings into cases of definite myocardial infarction, cases with occlusive coronary artery atheroma but no identifiable myocardial infarction, and non-cardiac cases. Pericardial fluid, peripheral venous blood, and blood from the right atrium were collected. Total creatine phosphokinase, creatine phosphokinase isoenzymes, aspartate aminotransferase and hydroxybutarate dehydrogenase activities were measured and the results analysed by logistic regression. RESULTS: The values of creatine phosphokinase and its isoenzymes were raised in those who had died of cardiac disease and were most discriminatory. Cases of early myocardial infarction without evidence of infarction on routine histological examination could be identified from enzyme activities. CONCLUSIONS: Measurement of cardiac enzymes in blood and pericardial fluid at necropsy can provide valuable additional information in cases of sudden death as a result of myocardial ischaemia which have occurred before macroscopic or microscopic evidence of myocardial infarction.

Full text

PDF
217

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Badir B., Knight B. Fluorescence microscopy in the detection of early myocardial infarction. Forensic Sci Int. 1987 May-Jun;34(1-2):99–102. doi: 10.1016/0379-0738(87)90088-0. [DOI] [PubMed] [Google Scholar]
  2. Bouchardy B., Majno G. Histopathology of early myocardial infarcts. A new approach. Am J Pathol. 1974 Feb;74(2):301–330. [PMC free article] [PubMed] [Google Scholar]
  3. Derias N. W., Adams C. W. Macroscopic enzyme histochemistry in myocardial infarction: use of coenzyme, cyanide, and phenazine methosulphate. J Clin Pathol. 1982 Apr;35(4):410–413. doi: 10.1136/jcp.35.4.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Derias N. W., Adams C. W. The non-specific nature of the myocardial wavy fibre. Histopathology. 1979 May;3(3):241–245. doi: 10.1111/j.1365-2559.1979.tb03001.x. [DOI] [PubMed] [Google Scholar]
  5. Knight B. A further evaluation of the reliability of the HBFP stain in demonstrating myocardial damage. Forensic Sci Int. 1979 May-Jun;13(3):179–181. doi: 10.1016/0379-0738(79)90285-8. [DOI] [PubMed] [Google Scholar]
  6. Lachica E., Villanueva E., Luna A. Comparison of different techniques for the postmortem diagnosis of myocardial infarction. Forensic Sci Int. 1988 Jul-Aug;38(1-2):21–26. doi: 10.1016/0379-0738(88)90005-9. [DOI] [PubMed] [Google Scholar]
  7. Lie J. T., Holley K. E., Kampa W. R., Titus J. L. New histochemical method for morphologic diagnosis of early stages of myocardial ischemia. Mayo Clin Proc. 1971 May;46(5):319–327. [PubMed] [Google Scholar]
  8. Luna A., Carmona A., Villanueva E. The postmortem determination of CK isozymes in the pericardial fluid in various causes of death. Forensic Sci Int. 1983 Jul;22(1):23–30. doi: 10.1016/0379-0738(83)90116-0. [DOI] [PubMed] [Google Scholar]
  9. Luna A., Villanueva E., Castellano M., Jimenez G. The determination of Ck, LDH and its isoenzymes in pericardial fluid and its application to the post-mortem diagnosis of myocardial infarction. Forensic Sci Int. 1982 Jan-Feb;19(1):85–91. doi: 10.1016/0379-0738(82)90154-2. [DOI] [PubMed] [Google Scholar]
  10. McVie J. G. Postmortem detection of inapparent myocardial infarction. J Clin Pathol. 1970 Apr;23(3):203–209. doi: 10.1136/jcp.23.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rammer L., Jansson O. Determination of electrolytes in the myocardium as a tool for the post-mortal diagnosis of recent infarction. Forensic Sci. 1976 Jul-Aug;8(1):127–130. doi: 10.1016/0300-9432(76)90055-8. [DOI] [PubMed] [Google Scholar]
  12. Sahai V. B., Knight B. The post-mortem detection of early myocardial infarction by a simple fluorescent method. Med Sci Law. 1976 Jan;16(1):17–20. doi: 10.1177/002580247601600106. [DOI] [PubMed] [Google Scholar]
  13. Stewart R. V., Zumwalt R. E., Hirsch C. S., Kaplan L. Postmortem diagnosis of myocardial disease by enzyme analysis of pericardial fluid. Am J Clin Pathol. 1984 Oct;82(4):411–417. doi: 10.1093/ajcp/82.4.411. [DOI] [PubMed] [Google Scholar]
  14. Varga M., Zsonda L. A simple method for postmortem detection of acute myocardial infarction. Forensic Sci Int. 1988 Jun;37(4):259–263. doi: 10.1016/0379-0738(88)90234-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES