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Histologic Findings of the Sinus Node and the Perinodal Area in Street Heroin Addicts, Victims of Sudden Unexpected Death

NCJ Number
234646
Journal
Journal of Forensic Sciences Volume: 56 Issue: 3 Dated: May 2011 Pages: 645-648
Author(s)
Christos E. Nerantzis, M.D., Ph.D.; Spyridon N. Koulouris, M.D., Ph.D.; Soultana K. Marianou, M.D.; Socrates C. Pastromas, M.D.; Philipos N. Koutsaftis, M.D.; Emmanuel B. Agapitos, M.D., Ph.D.
Date Published
May 2011
Length
4 pages
Annotation
Sudden unexpected death is frequent in street heroin addicts. This histologic study of the sinus node (SN) offers some evidence about the possible arrhythmogenic cause of death.
Abstract
Postmortem coronary angiography and microscopic examination of the SN and the perinodal area were performed in 50 heroin addicts (group 1) and in 50 nonaddicts (group 2), all men (16-40 years old). In heroin addicts, fatty and/or fibrous tissue replaced SN tissue in 21 cases (42 percent). Perinodal infiltration was found in 15 cases (30 percent). Fibromuscular dysplasia in branches of the sinus node artery (SNA) was found in eight cases (16 percent). Inflammation with focal and/or diffuse concentration of round cells was detected in the SN in 22 cases (44 percent). Old mural thrombi were also found in 13 cases (26 percent). The histologic changes in the SN and perinodal area offer an explanation about the possible mechanism of arrhythmia and sudden death in this population. (Published Abstract)