Forensic medical characteristic of the stromal component of myocardial tissue in cases of death from alcoholic cardiomyopathy

A histological examination of the stromal component of myocardial tissue, which is one of the main components of the histohematological barrier, in cases of alcoholic cardiomyopathy, revealed a set of morphological changes, the development of which is caused by a cascade of pathological processes which were resulted from prolonged toxic effects on the cardiac muscle of ethanol and its metabolites. Morphological changes of the stromal component of the histohematological barrier of the myocardium in the form of metabolic and replaceable sclerosis have been revealed. The immediate role in the processes of the formation of metabolic sclerosis, manifested as perimuscular cardiosclerosis and perivascular cardiosclerosis, is played by hypoxia, caused by the toxic effect of ethanol and its metabolites on the main structural components of the vascular walls of the microcirculatory bed with the development of their increased permeability. Sclerosis processes during the formation of pleximorphic cardiosclerosis in alcoholic cardiomyopathy are of a substitutionary nature, the development of which is associated with the alteration of cardiomyocytes, caused both by direct toxic effects on the myocytes of ethanol and its metabolites, and by progressive hypoxia phenomena. The revealed features of the spread of pleximorphic cardiosclerosis in the myocardium testify to the mosaic damage of the cardiac muscle in alcoholic cardiomyopathy. It is established that the relative area of the stroma of the myocardium does not depend on the age and sex belonging to those who died from alcoholic cardiomyopathy. The relative area of the stroma was almost the same in all the dead and did not have significant differences.