Features or forensic pathology in sudden cardiac death: are there histologic indicators of acute myocardial ischemia?
Cruz, Frederic Anthony Silo
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The following thesis proposes the question if current scientific data supports the hypothesis that an acute myocardial infarction, not identified by gross symptoms, can be visualized by using apoptotic signaling biomarkers as a diagnostic tool to complement a post-mortem autopsy. The biochemistry and mechanisms of irreversible cellular death is presented and supported through published experimental, clinical and case studies. Furthermore, the aforesaid biomarkers have been observed in the cardiac myocyte in elevated levels associated with hypoxic ischemia. In addition, the physical characteristic of DNA fragmentation is addressed to visualize apoptotic injury due to hypoxic ischemic conditions. Although the quality of evidence lacked published data to suggest one immunochemical staining method positively identifies a myocardial infarction, there is adequate data to suggest that a combination of staining methods can be utilized as a tool to positively identify and diagnose an acute myocardial infarction.
Thesis (M.S.)--Boston University