Abstract:
Background Cardiovascular diseases, especially ischemic heart disease, are the most frequent cause of sudden and unexpected death that constitute a significant portion of the autopsies conducted in our country. Though these deaths may be natural as well as unnatural, they carry medico-legal importance because they occur in a person who has been apparently healthy before the supervening of death, and the cause of death is difficult to ascertain. An infarction can be missed by gross and histological examination within the first few hours of sudden death. 2,3,5-triphenyl-tetrazolium chloride (TTC) is a sensitive histochemical method for diagnosing myocardial infarction within four hours of sudden death. The use of such dyes, hence, can possibly aid in ascertaining the cause of death in such cases wherein there are no known preceding factors. Aim The aim of this article was to study the occurrence of myocardial ischemia by histochemical staining method - 2,3,5-triphenyl-tetrazolium chloride (TTC). Methods This study involved patients who underwent postmortem examination in the Department of Forensic Medicine and Toxicology, Sri Ramachandra Medical College and Research Institute, Chennai. Results Of 62 cases, 31 cases were found to be positive for TTC staining, and those heart slices were subjected to histopathological examination. The maximum number of cases (77.4%) showed the age of infarction within zero to four hours, which was detected early by TTC staining compared to microscopic changes in the heart. Only seven cases were positive for myocardial infarction by histopathological examination, proving that it is difficult to detect acute infarction if the age of infarction is less than four hours. Conclusion This suggests that for all sudden death cases, 2,3,5-triphenyl tetrazolium chloride could be used as a better tool for the identification of early infarcts.
摘要:
背景心血管疾病,尤其是缺血性心脏病,是导致猝死和意外死亡的最常见原因,而猝死和意外死亡在我国进行的尸检中占了很大一部分。虽然这些死亡可能是自然的,也可能是不自然的,它们具有医学法律重要性,因为它们发生在一个在死亡之前明显健康的人身上,死因很难确定。在猝死的最初几个小时内,通过肉眼和组织学检查可能会错过梗塞。氯化2,3,5-三苯基-四唑(TTC)是一种灵敏的组织化学方法,可在猝死后4小时内诊断心肌梗死。这种染料的使用,因此,在没有已知先前因素的情况下,可能有助于确定死亡原因。目的通过组织化学染色法-2,3,5-三苯基-氯化四唑(TTC)研究心肌缺血的发生。方法这项研究涉及在法医学和毒理学科接受尸检的患者,SriRamachandra医学院和研究所,钦奈.结果62例,31例TTC染色阳性,这些心脏切片接受了组织病理学检查。最大病例数(77.4%)显示梗死年龄在零至四小时内,与心脏的微观变化相比,早期通过TTC染色检测到。仅7例组织病理学检查为心肌梗死阳性,证明如果梗塞年龄小于四小时,很难发现急性梗塞。结论这表明,对于所有猝死病例,氯化2,3,5-三苯基四唑可作为早期梗死的较好鉴定工具。