Right coronary artery supplies blood to
electrical area of heart
The most common cause of sudden cardiac
death in adults over the age of forty was coronary artery atheroma seen in
postmortem examination in about 100 cases randomly selected by me in AIIMS mortuary.
- The most common finding at
postmortem examination is chronic high–grade stenosis of minimum one
segment of a major coronary artery, the arteries which supply the heart
muscle with its blood supply.
- A significant number of cases also
have an identifiable clot in a major coronary artery which causes
transmural occlusion of that vessel.
- In 75 cases out of hundreds, the
clots were seen in right coronary artery supplying the electrical area of
heart.
- Death in these cases is thought to
result from a period of transient or prolonged lack of blood supply in the
muscle of the heart wall, which induces a ventricular
arrhythmia/fibrillation and no changes in the myocardium are seen during
postmortem examination.
- The absence of the histological
signs of acute necrosis and a healed infarct are a common finding.
- Chronic high–grade stenosis
causing previous episodes of ischemia and areas of focal fibrosis is seen
histologically in the myocardium.
- Ventricular arrhythmias may arise
from a myocardium which has been previously scarred by episodes of
ischemia.
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