Histopathological array of cardiac lesions: An autopsy based study in a tertiary care centre

Background: Cardiac lesions are responsible for approximately 60-70% of sudden deaths. Histopathological examination of heart on autopsy plays an essential role in determining the cause of death. Aims and Objectives: The present study was conducted to analyse histopathological spectrum of various cardiac lesions in autopsy specimens. Materials and Methods: This retrospective randomized study was conducted in the Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana. A total of 1152 autopsies were analysed, irrespective of cause of death. Among them heart was included in 1062 autopsies, out of which 62 were autolysed. Hence, 1000 specimen of whole heart were included in our study. A detailed gross and microscopic examination was done and histopathological findings were correlated clinically. Results: Atherosclerosis was the most common cardiac lesion seen in 610 out of 1000 autopsied heart (61%), followed by ischaemic heart disease in 346 cases (34.6%). 27 cases had pericarditis, 23 cases revealed myocardial hypertrophy, 16 cases showed myocarditis, 11 cases had ventricular haemorrhage, 8 cases revealed changes of electrocution, 7 cases had tuberculosis, 6 cases had calcification of valve and 4 cases had metastasis from carcinoma. One case each of infective endocarditis, rheumatic heart disease and aortitis were also noted. The cause of death was not identified in 304 cases. Left anterior descending artery was most frequently involved vessels (35.02%) followed by left circumflex artery (33.41%) then right coronary artery (31.57%). Out of three major vessels 16.24% had single vessel involvement whereas 32.14% & 51.62% cases had two vessels and three vessels involvement respectively. Conclusion: Ischemic heart disease with coronary artery atherosclerosis was found to be the leading cause of death with triple vessel disease as the most common pattern of involvement. Keywords: Autopsy, Heart, Histopathology.