CardiomyopathyComparison of Necropsy Findings in Patients With Sarcoidosis Dying Suddenly from Cardiac Sarcoidosis Versus Dying Suddenly from Other Causes
Section snippets
Methods
A retrospective search was performed from 1995 to 2008 for hearts seen in consultation at the Armed Forces Institute Pathology, Office of the Armed Forces Medical Examiner, and Office of the Chief Medical Examiner, evaluated in a uniform fashion by 1 of the coauthors (A.B.). All cases with the diagnosis of “sarcoid” in the history or diagnosis, with gross and microscopic materials available, were retained for the present study. Only cases of sudden death were included.
The gross extent of
Results
A total of 46 cases of sudden death were found with “sarcoid” in either the clinical history or cardiac findings. Of these 46 patients, 16 had a history of sarcoid, and, of these, 5 had no cardiac involvement, 6 died from cardiac sarcoid, and 5 had incidental cardiac sarcoidosis at autopsy. Of the 41 patients with cardiac sarcoidosis at autopsy, the cause of sudden death was attributed to sarcoid in 25 (group 1, Table 1) and other factors in 16 (group 2, Table 2). No differences were found in
Discussion
The present autopsy study sampled 1 subset of symptomatic cardiac sarcoidosis, namely that resulting in sudden death. Because of autopsy selection bias, especially in cases referred to the Medical Examiner's Office, only a small proportion of patients (1 in the entire study) had a history of cardiac sarcoidosis, because patients with a history of heart disease are often not subject to forensic evaluation. Therefore, the study findings are based on a selected group of patients with cardiac
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