Right coronary artery supplies blood to
electrical area of heart
The most common cause of sudden cardiac
death in adults over the age of 40 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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