Abstract
The autopsy examination of cardiac tissues is described in detail with stepwise consideration of the individual components of the heart. The approach to common pathological processes is provided. There is a stepwise photographic illustration of the dissection technique together with discussion of the appropriate histological investigations, special stains, ultrastructural histology and ancillary tests. The method for cardiac conduction system assessment is demonstrated and an approach to various cardiac devices is discussed. The value of post-mortem radiology (PM-CT) scanning of cardiac disease is described, along with examples of radiology images.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Basso C, Aguilera B, Banner J, et al. Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology. Virchows Arch. https://doi.org/10.1007/s00428-017-2221-0.
Suvarna SK. National guidelines for adult autopsy cardiac dissection: are they achievable? Histopathology. 2008;53:97–112.
Suvarna SK. External examination. In: Atlas of adult autopsy. New York, NY: Springer; 2016. p. 13–46.
Burton J, Saunders S, Hamilton S. Atlas of adult autopsy pathology. Boca Raton, FL: CRC Press; 2015.
Rutty GN, Burton JL. The evisceration. In: Burton JL, Rutty GN, editors. The hospital autopsy. 3rd ed. London: Arnold; 2010. p. 115–35.
Suvarna SK, Coe MS. Evisceration & thorax. In: Suvarna SK, editor. Atlas of adult autopsy. A guide to modern practice. New York, NY: Springer; 2016. p. 47–160.
Farrer-Brown G. A colour atlas of cardiac pathology. London: Wolfe Medical Publications Ltd; 1977. p. 88–91.
Rutty GN, Burton JL. Dissection of the internal organs. In: Burton JL, Rutty GN, editors. The hospital autopsy. 3rd ed. London: Arnold; 2010. p. 136–58.
Edwards WD. Cardiovascular system. In: Ludwig J, editor. Autopsy practice. 3rd ed. Toronto, WA: Humana; 2002. p. 21–43.
Becker AE, Anderson RH. Cardiac adaptation and its sequelae. In: Cardiac pathology. An integrated text and color atlas, vol. 1. Edinburgh: Churchill Livingstone; 1982. p. 2–1.8.
Silver MM, Silver MD. Examination of the heart and cardiovascular specimens in surgical pathology. In: Silver MD, Gotlieb AI, Schoen FJ, editors. Cardiovascular pathology. 3rd ed. New York, NY: Churchill Livingstone; 2001. p. 1–29.
Burke AP, Aubrey M-C, Malezewski JJ, Alexiev B, Tavora FR. Practical thoracic pathology. Diseases of the lung, heart and thymus. Philadelphia, PA: Wolters-Kluwer; 2017. p. 573–887.
Kitson DW, Scholz DG, Hagen PT, Ilstrup DM, Edwards WD. Age-related changes in normal human heart during the first ten decades of life. Part II. Maturity: a quantitative anatomical study of 765 specimens from subjects 20–99 years old. Mayo Clin Proc. 1988;63:137–46.
Lucas SL. Derivation of new reference tables for human heart weights in light of increasing body mass index. J Clin Pathol. 2011;64:279–80.
Gaitskell K, Perera R, Soilleux EJ. Derivation of new reference tables for human heart weights in light of increasing body mass index. J Clin Pathol. 2011;64:358–62.
Bradshaw SH, Kennedy L, Dexter DF, Veinot JP. A practical method to rapidly dissolve metallic stents. Cardiovasc Pathol. 2009;18(3):127–33. https://doi.org/10.1016/j.carpath.2009.01.001.
Palmerini T, Biondii-Zoccai G, Dela-Riva D, et al. Clinical outcomes with bioabsorbable polymer- versus durable polymer-based drug-eluting and bare-metal stents. Evidence from a comprehensive network meta-analysis. J Am Coll Cardiol. 2014;63(4):299–307.
Waksman R, Pakala R. Biodegradable and bioabsorbable stents. Curr Pharm Des. 2010;16(36):4041–51.
Anderson RH, Becker AE. Normal cardiac anatomy. In: Anderson RH, Becker AE, Roberts WB, editors. The cardiovascular system. Part A: general considerations and congenital malformations. Edinburgh: Churchill Livingstone; 1993. p. 3–26.
Raasch F. Pacemaker post-mortem. In: Legal medicine annual. Boston, MA: Butterworth; 1997. p. 97–100.
Suvarna SK, Start RD, Tayler DI. A prospective audit of pacemaker function, implant lifetime and patient cause of death. J Clin Pathol. 1999;52:677–80.
Prahlow JA, Guilleyardo JM, Barnard JJ. The implantable cardioverter defibrillator. A potential hazard for autopsy pathologists. Arch Pathol Lab Med. 1997;121:1076–80.
Fulton RM, Hutchinson EC, Morgan Jones A. Ventricular weight in cardiac hypertrophy. Br Heart J. 1952;14:413–20. https://doi.org/10.1136/hrt.14.3.413.
Schoen FJ. Approach to the analysis of cardiac valve prostheses as surgical pathology or autopsy specimens. Cardiovasc Pathol. 1995;4:241–55.
Luk A, Rao V, Cusimano RJ, David TE, Butany J. CorMatrix extracellular matrix used for valve repair in the adult: is there de novo valvular tissue seen? Ann Thorac Surg. 2015;99:2205–7.
Chand M, Lamagni T, Kranzer K, et al. Insidious risk of severe Mycobacterium chimaera infection in cardiac surgery patients. Clin Infect Dis. 2017;64(3):335–42.
The Royal College of Pathologists. Tissue pathways for cardiovascular pathology. www.rcpath.org/.
The Royal College of Pathologists. Guidelines on autopsy practice: scenario 1: sudden death with likely cardiac pathology. www.rcpath.org/.
Tester DJ, Ackerman MJ. The role of molecular autopsy in unexplained sudden cardiac death. Curr Opin Cardiol. 2006;21:166–72.
Thali M, Dirhofer R, Vock P, editors. The virtopsy approach: 3D optical and radiological scanning and reconstruction in forensic medicine. Boca Raton, FL: CRC Press; 2009.
Grabherr S, Grimm JM, Heinemann A. Atlas of postmortem angiography. New York, NY: Springer; 2016.
Roberts ISD, Traill ZC. The radiological autopsy. In: Suvarna SK, editor. Atlas of adult autopsy: a guide to current practice. London: Springer; 2016.
der Bijl N, Joemai RMS, Gelejnes J, et al. Assessment of Agatston coronary artery calcium score using contrast-enhanced CT coronary angiography. Am J Roentgen. 2010;195:1299–305.
Acknowledgements
Grateful thanks are expressed to Mr. B. Wagner, Senior Electron Microscopist, Sheffield Teaching Hospitals for his expertise and photography of ultrastructural histology in this chapter.
Especial thanks are given to iGene Digital Autopsy services, UK, who have ably assisted and guided me and my interaction with autopsy radiology (PM-CT). They have been generous in making images available for this chapter. Their interaction with Sheffield autopsy services has been ground-breaking in my opinion.
I am also grateful to the Forensic Pathology unit in Lausanne, Switzerland for the opportunity to see the Virtopsy practice.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Suvarna, S.K. (2019). The Heart at Autopsy, Including Radiological Autopsy of the Heart. In: Suvarna, S. (eds) Cardiac Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24560-3_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-24560-3_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-24559-7
Online ISBN: 978-3-030-24560-3
eBook Packages: MedicineMedicine (R0)