Immunoreactivity of Cardiac Troponin, Myoglobin, and Caspase 3 revealing the connection of Acute myocardial Infarction with Acute Lung Injury in autopsied cases of sudden/ unexpected deaths

Document Type : Original Article

Authors

1 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Helwan University, Egypt

2 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Egypt

3 Pathology Department, Faculty of Medicine, Helwan University, Egypt.

Abstract

Background: Sudden and unexplained deaths present challenges for
forensic pathologists to determine underlying causes. Many disorders are
cardiovascular in nature, although little research has been done on non- cardiac involvement, such as lung disease. This study investigates the
correlation between acute myocardial infarction (AMI) and acute lung
injury (ALI) in these types of fatalities. Methods: This study examined 80 autopsy cases of unexpected or
unexplained deaths that had been in Egypt between 2009 and 2014. Hematoxylin and eosin staining and immunohistochemistry employing
cardiac markers such as troponin, myoglobin, and caspase 3 were used
to examine lung and heart tissues. Results: While 65% of individuals had additional lung diseases, about
35% of cases had signs of ALI. About 60% of people had coronary
artery disease and 40% had cardiac muscle damage. Cases examined
by HE & E showed no statistically significant relation or association
between ALI and AMI cases. Unlike results with conventional staining, immunohistochemistry revealed a substantial correlation between mild
indications of AMI and ALI. Conclusion: The findings raise the possibility of myocardial damage
associated ALI which by turn increases the incidence of sudden or
unexpected deaths. For ALI patients, routine cardiac enzyme testing is
advised to rule out cardiac involvement. Additional investigation into
the pathways linking AMI and ALI is necessary

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