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Cardiovascular Conditions and the Evaluation of the Heart in Pregnancy‐Associated Autopsies
Author(s) -
Herbst Jonathon,
Winskog Calle,
Byard Roger W.
Publication year - 2010
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/j.1556-4029.2010.01489.x
Subject(s) - medicine , autopsy , pregnancy , myocardial infarction , sudden death , aortic dissection , cause of death , dissection (medical) , forensic pathology , cardiomyopathy , maternal death , marfan syndrome , sudden cardiac death , cardiology , surgery , heart failure , aorta , population , disease , genetics , environmental health , biology
Pregnancy‐associated death is defined as the death of a woman from any cause during pregnancy or in the year after delivery. This review concentrates on cardiac conditions that may result in pregnancy‐associated death including, but not limited to, acute myocardial infarction, endocarditis, peripartum cardiomyopathy, and prolonged QT syndrome. Lethal vascular conditions may also occur involving arterial dissection and thromboembolism, on occasion exacerbated by hypercoagulability, and altered hormonal and physiologic states. The autopsy evaluation of these patients includes a careful assessment of the medical history particularly for prior pregnancy‐related conditions, fetal loss, and episodes of unexplained collapse. A family history of sudden death at an early age may be significant. At autopsy, evaluation for underlying syndromes such as Marfan, or evidence of intravenous narcotism should be undertaken. Autopsy examination involves careful dissection of the heart and vessels with consideration of conduction tract studies and possible genetic evaluation for prolonged QT syndrome.