Spectrum of histopathological lesions of heart: An autopsy study at tertiary care center

Background: There has been a notable rise in cardiac-related fatalities globally, especially in the last five decades. In India, ischemic heart disease has become prevalent, affecting roughly 10% of the population. For forensic specialists, establishing the cause of death in individuals previously in good health can be complex. Autopsies are crucial in evaluating the underlying factors responsible for such deaths. This research seeks to identify and scrutinize a wide range of histopathological heart abnormalities that significantly influence the determination of the cause of death. Materials and Methods: This study was conducted in the Department of Pathology from January 2020 to December 2020. During this period, we received a total of 209 whole heart specimens. Of these, 208 specimens underwent comprehensive examinations, including macroscopic and microscopic observations. Results: Out of the 208 cases examined, 94 showed evidence of both early and advanced atherosclerosis, whereas 65 showed early and late signs of myocardial infarction. Myocardial hypertrophy was evident in 29 patients. Isolated instances of myocarditis and pericarditis were observed in one case each. Fatty streaks were identified in 32 cases; three showed red blood cells with sickle cell morphology. Heart rupture was detected in one case, and another revealed metastasis from a poorly differentiated tumor. Notably, in 90 cases, the cause of death remained undetermined despite thorough macroscopic and microscopic autopsies. Conclusion: The primary reason for cardiovascular fatalities is atherosclerosis-related myocardial infarction.