Atherosclerotic changes in aorta and coronary arteries at autopsy in North Indian population

Authors

  • Kunal Khanna Department of Forensic Medicine, Kalpana Chawla Government Medical College, Karnal, Haryana, India
  • Varun Garg Department of Forensic Medicine, Dr. Baba Sahib Ambedkar Medical College and Hospital, Rohini, Delhi, India
  • Vijay Pal Khanagwal Department of Forensic Medicine, Kalpana Chawla Government Medical College, Karnal, Haryana, India
  • Tarun Dagar Department of Forensic Medicine, Dr. Radhakrishnan Govt. Medical College, Hamirpur, Himachal Pradesh, India
  • Pramod Kumar Paliwal Department of Forensic Medicine, Pt. BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
  • Rajeev Sen Department of Pathology, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20193249

Keywords:

Atheroma, Autopsy, Calcification, Fibro-fatty plaques, Occlusion

Abstract

Background: Cardiovascular disease (CVD) has become a ubiquitous cause of morbidity and a leading contributor to mortality in most countries. It has emerged as a major health burden worldwide with atherosclerosis being the major cause.

Methods: 150 random cases of different age groups brought for postmortem examination in the Department of Forensic Medicine PGIMS, Rohtak.  Heart was removed and examined after obtaining the consent of next of the kin of the deceased. Gross macroscopic changes were noted and microscopic changes examination was done and reported by preparation of slides in collaboration with Department of Pathology of the Institute.

Results: The study group comprised of mostly males (70%) with mean age of 36.90±13.88 years. Almost half of them were in their third and fourth decade of life. 83 cases were found to have atherosclerosis and 25 of them belonged to the age group 40 to 49 years. 82 % of these cases were of male gender. Histopathological grading carried out displayed that Grade III lesions were maximum (27.5%) followed by grade IV lesions (19.0%) and in no section grade VIII lesions were seen.

Conclusion: Atherosclerosis has emerged as a new epidemic affecting at a relatively younger age. This study would help in planning of preventive measures directed at the right population. Clinicians could take measures at an early stage to prevent the progression of the disease and will help forensic pathologists in dealing with opinion regarding cause of death.

References

Gaziano T, Reddy KS, Paccaud F, Horton S, Chaturvedi V. Cardiovascular Disease In: Jamison DT, Breman JG, Measham AR, Evans DB, Jha P, Mills A, Musgrove P, et al. eds. Disease control priorities in developing world. Oxford: Oxford University Press; 2006: 645-662.

Leeder S, Raymond S, Greenberg H. A race against time: the challenge of cardiovascular disease in developing economies. Columbia University, New York City New York; 2004.

Chauhan S, Aeri BT. Prevalence of cardiovascular disease in India and its economic impact- a review. Int J Scientific Res Publ. 2013;3(10):1-5.

Wig KL, Malhotra RP, Chitkara NL, Gupta SP. Prevalence of Coronary Atherosclerosis in Northern India. BMJ. 1962;2:510-3.

Golshahi J, Rojabi P, Golshahi F. Frequency of atherosclerotic lesions in coronary arteries of autopsy specimens in Isfahan forensic medicine Center. J Res med. 2005;1(10):16-9.

Yazdi SA, Rezaei A, Azari JB. Prevalence of atherosclerotic plaque in autopsy cases with non-cardiac death. Iran J Pathol. 2009;4:101-4.

Naher S, Naushaba S, Muktadir G. Percentage area of intimal surface of the abdominal aorta affected by atherosclerosis: a postmortem study. J Med Sci Res. 2007;9:26-30.

Garg M, Aggarwal AD, Kataria SP. Coronary atherosclerosis and myocardial infarction: An autopsy study. J Indian Acad Forensic Med. 2011;33(1):39-42.

Virmani R, Robinowitz M, McAllister HA Jr. Coronary heart disease in 48 autopsy patients 30 years old and younger. Arch Pathol Lab Med. 1983;107(10):535-40.

Thej MJ, Kalyani R, Kiran J. Atherosclerosis in coronary artery and aorta in semi-urban population by applying modified American Heart Association classification of atherosclerosis: an autopsy study. J Cardiovasc Dis Res. 2012;3:265-71.

Puri N, Gupta PK, Sharma J, Puri D. Prevalence of atherosclerosis in coronary artery and internal thoracic artery and its correlation in North-West Indians. Indian J Thorac Cardiovasc Surg. 2010;26:243-6.

Holman RL, McGill HC Jr, Strong JP, Geer JC. The natural history of atherosclerosis the early aortic lesions as seen in New Orleans in the middle of the 20th century. Am J Pathol. 1958;34:209-35.

Strong JP. Coronary Atherosclerosis in soldiers: a clue to the natural history of atherosclerosis in the young. 1986;256(20):2863-6.

Joseph A, Ackerman D, Talley JD, Jhonstone J, Kupersmith J. Manifestations of coronary atherosclerosis in young trauma victim: an autopsy study. J Am Coll Cardiol. 1993;22(2):459-67.

Singh V, Pai MR, Coimbatore RV, Naik R. Coronary atherosclerosis in Mangalore: A random post-mortem study. Indian J Pathol Microbiol. 2001;44(3):265-9.

Kumar S, Kumar VA, Kumar N. Coronary atherosclerosis: a post-mortem histopathological study. Bratisl Lek Listy. 2012;113(4):217-9.

Virmani R, Rrbinowitz M, Geer JC. Coronary artery atherosclerosis revisited in Korean war combat casualties. Arch Pathol Lab Med. 1987;111:972-6.

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Published

2019-07-24

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Original Research Articles