13 Death Dt Natural Causes Flashcards
Causes of sudden and unexpected death
- always in CVS
- cerebral haemorrhage dt MVA
- subarachnoid haemorrhage dt ruptured berrry aneurysm
- ruptured ectopic pregnancy
- haemoptysis dt PTB
- haematemesis dt rultured esophageal varices
- PE
- ruptured aortic aneurysm
Cx in coronary atheroma
- ulcerated plaques
- haemorrhage within the plaques
- coronary thrombus
Most common sites of coronary stenosis and occlusion
- L ant descending coronary artery
- R coronary artery
- L circumflex artery
**almost all infarcts are in left ventricle
Causes of MI
- coronary atheroma
- polyartheritis of coronary
- coronary embolism
- ostial occlusion by syphilis
- aortic stenosis
Process of early MI
- oedema and pallor muscle (hours)
- tigroid appearance/yellow and haemorrhagic areas (days)
- myomalacia cordis leading to ruptured infarct (days to weeks)
- gelatinous and greyish (weeks)
- myocardial fibrosis (months)
Cx of MI
- ruptured heart leading to haemopericardium and cardiac temponade
- mural thrombus in L ventricle
- pericarditis
- myocardial fibrosis in L ventricle (septum and posterior)
- cardiac aneurysm in L ventricle (lateral)
Mechanism of CAD
- myocardial hypoxia leads to AF and Ventricular fibrillation and cardiac arrest and death
How hypertensive heart disease cause MI
- concentric hypertrophy of L ventricle
- insufficient supply of blood
- causing MI
500-700g
Aortic valve ds
- which type occur in elderly and how it occurs
- calcific aortic stenosis usually in elderly
- valve thickened and rigid, fusion of valvular commissures and vegetation on cusps
What is cardiomyopathy and most commonly occur in which age
Absence of HTN or valvular ds
Usually in young adults
Types of cardiomyopathies
- congestive
- hypertrophic (interventricular septum)
- obliterative
Histology of hypertrophic CM
- irregular and large fibres
- nuclear pleomorphism
- criss cross muscle fibres
- interstitial fibrosis
Cause and histology of myocarditis
- unknown aetiology
- 100 or more inflammatory infiltrates with myocyte necrosis
Definition Senile myocardium
Findings
Histology
- myocardial degeneration due to senility
- findings: heart is brown and flabby soft. The coronary vessels are torturous
Histology: lipofuscin pigments in nuclei, diffuse fibrosis of myocardium
Types of ruptured aortic aneurysm and patho
- atheromatous aneurysm: media destruction dt fibrolipid degeneration
- dissecting aneurysm: dt degeneration of aortic media (medianecrosis)
- syphilitic aneurysm
Cause of cerebral bleeding in children
- angioma
- AV anastomosis
Common sites of cerebral bleeding in children
- bifurcation of middle cerebral artery and post comm artery
- bifurcation of basilar arteries
- middle cerebral artery
- ant comm artery
Predisposing fx of pulm thromboembolism
- trauma
- surgery
- bed ridden
- immobility
Findings of epilepsy
- tongue bite marks, patchy myocardial fibrosis
How bronchial asthma cause death and findings
- dt overuse of inhalers causing hypoxia and respiratory acidosis.
- causing ventricular fibrillation dt theophylline and sympathomimetics
Findings: lung expanded, pale spongy lung, thick clear mucus in bronchus
Causes of respiratory obstruction
- rupture of retropharyngeal abscess (‘quincy’)
- laryngeal obstruction in diphteria
- laryngeal oedema from epiglottis (children)
Causes and mechanism haemoptysis
Causes
- dt pulm tuberculosis and bronchial tumours (eroding large vessels)
Mechanism
- causing asphyxia or vagal inhibition (sudden flooding of larynx)
Causes of GI haemorrhage
- esophageal carcinoma
- ruptured esophageal varices
- gastric ulcer and peptic ulcer
- carcinoma of stomach
Causes of intestinal haemorrhage
- haemorrhagic diathesis
- colonic ca
- ulcerative colitis
- colonic polyp
Causes of abdominal catastrophes
- mesentric thrombosis and infarction
- strangulated intestine
- hernia (femoral and inguinal)
Patho of PE, when is it occur
Virchows triad
- slowing of circulation (stasis)
- local injury to vessel wall (endothelial injury)
- increase blood coagulability (hypercoagulability)
Occur 2 weeks after trauma, range from 2-90 days
