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Histological Findings of the Atrioventricular Conductive System in Street Heroin Addicts, Victims of Sudden Unexpected Death

NCJ Number
243688
Journal
Journal of Forensic Sciences Volume: 58 Issue: S 1 Dated: January 2013 Pages: S 99-S 104
Author(s)
Christos E. Nerantzis, M.D., Ph.D.; Constantinos M. Couvaris, M.D.; Socrates C. Pastromas, M.D.; Soultana K. Marianou, M.D.; Ilias D. Boghiokas, M.D., Ph.D.; Philippos N. Koutsaftis, M.D., Ph.D.
Date Published
January 2013
Length
6 pages
Annotation
A study of the atrioventricular (AV) conducting tissue was considered necessary for the examination of probable histologic changes that could justify the arrhythmias observed in street-heroin addicts.
Abstract
A study of the atrioventricular (AV) conducting tissue was considered necessary for the examination of probable histologic changes that could justify the arrhythmias observed in street-heroin addicts. Postmortem coronary angiography and microscopic examination were performed in 50 heroin addicts (group A) and in 50 nonaddicts (group B), all male 16-40 years old. In group A, fatty and/or fibrous tissue replaced the AV node in 50 percent of cases while in group B in 14 percent. The main bundle was replaced by fatty and/or fibrous tissue in 44 percent in group A cases and 10 percent in group B. Intimal proliferation and fibromuscular dysplasia of the AV arteries in group A were correspondingly 26 percent and 14 percent and in group B 6 percent and 2 percent. Inflammation with focal and/or diffuse concentration of round cells of the AV node was detected in 54 percent in group A. These findings could explain a possible arrhythmia mechanism in this population. Abstract published by arrangement with John Wiley & Sons.