Neural Pathology of the Heart in Sudden Death
When sudden death occurs unexpectedly and cannot be explained by usual findings or circumstances, most now believe that the terminal event was a lethal disturbance of the electrical activity of the heart. By contrast to occasionally fatal instability, there is normally a remarkable stability of cardiac rhythm and conduction which. is marvelously durable under a continuing barrage of changes in demand on the work of the heart. Many different factors contribute to this durable stability. Familiar ones include changes in the contractile property of myocardium and in the pattern of coronary flow. It is not generally appreciated how important autonomic neural control is to almost every facet of this stable performance, including not only cardiac contraction and coronary flow, but also every component of the heart’s electrophysiological function. Nerves influence the rate at which the heart beats, the nature of its rhythm, the speed and route by which it conducts its electrical impulse, and the process by which both the atrial and ventricular myocardium becomes repolarized.
KeywordsThrombotic Thrombocytopenic Purpura Sinus Node Ventricular Myocardium Neural Control Ventricular Repolarization
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- 1.Rossi L: Histopathology of cardiac arrhythmias ( second edition ). Casa Editrice Ambrosiana, Milano, 1978.Google Scholar
- 3.Burgess MJ: Relation of ventricular repolarization to electrocardiographic T wave-form and arrhythmia vulnerability. Am J Physiol 5: H391 - H402, 1979.Google Scholar
- 5.James TN: Cardiac innervation: Anatomic and pharmacologic relations. Bull NY Acad Med 43: 1041–1086, 1967.Google Scholar
- 17.Rossi L, James TN: Neurovascular pathology of the heart in progressive muscular dystrophy. Panminerva Med 6: 357–360, 1964.Google Scholar
- 21.James TN, Froggatt P, Atkinson WJ, Lurie PR, McNamara DG, Miller WW, Schloss GT, Carroll JF, North RL: De Subitaneis Mortibus. XXX. Observations on the pathophysiology of the long QT syndromes with special reference to the neuropathology of the heart. Circulation 57: 1221–1231, 1978.PubMedGoogle Scholar
- 26.Romano C, Gemme G, Pongiglione R: Aritmie Cardiache Rare Dell’eta’ Pediatrica. II. Accessi sincopali per fibrillazione ventricolare parossistica. (Presentazione del primo case della letteratura pediatrica italiana.) Clin Pediat 45: 656–683, 1963.Google Scholar
- 27.Ward OC: A new familial cardiac syndrome in children. J Irish Med Assn 54: 103–106, 1964.Google Scholar
- 38.Urthaler F, James TN: Cholinergic and adrenergic control of the sinus node and AV junction. Chapter 9 in Neural Regulation of the Heart, Randall WC (ed), Oxford University Press, New York, 1977, p 247–288.Google Scholar