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Fibromuskuläre Dysplasie und akuter Herztod

Kurzübersicht

Fibromuscular dysplasia and sudden cardiac death

Brief review

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Zusammenfassung

In einer Übersicht wird das Krankheitsbild der fibromuskulären Dysplasie (FMD) aus rechtsmedizinischer Sicht in übersichtlicher Form vorgestellt. Die FMD kann jede Arterie und/oder die Aorta befallen und isoliert oder bei verschiedenen Arterien gleichzeitig auftreten. Symptome und Folgen der Erkrankung sind von der Lokalisation und der Ausprägung der Gefäßwandveränderungen abhängig. Während die FMD der Nierenarterien und der zervikalen Arterien in der klinischen Praxis eine erhebliche Relevanz aufweist, kommen Rechtsmediziner und Pathologen, die unklare Todesfälle untersuchen, eher mit der FMD der Herzarterien in Berührung. In der Literatur finden sich zahlreiche Kasuistiken; hierbei wird im Zusammenhang mit der Todesursache die FMD der Atrioventrikulären-(AV-)Knoten-Arterie am häufigsten erwähnt.

Abstract

In the present review fibromuscular dysplasia (FMD) is presented from a forensic medical point of view. Every artery can be affected by FMD including the aorta and can occur simultaneously either isolated or in different arteries. The symptoms and consequences of FMD depend on the localization and the severity of the arterial wall changes. While FMD of the renal arteries and the cervical arteries has substantial relevance in clinical practice, forensic pathologists who examine sudden unexpected deaths, observe FMD more frequently in arteries of the heart. There are several case reports in the literature whereby FMD of the atrioventricular (av) node artery is most frequently mentioned in connection with the cause of death.

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Literatur

  1. Anderson KR, Bowie J, Dempster AG, Gwynne JF (1981) Sudden death from occlusive disease of the atrioventricular node artery. Pathology 13:417–421

    Article  PubMed  CAS  Google Scholar 

  2. Anderson KR, Hill RW (1982) Occlusive lesions of cardiac conducting tissue arteries in sudden infant death syndrome. Pediatrics 69:50–52

    PubMed  CAS  Google Scholar 

  3. Begelmann SM, Olin JW (2000) Fibromuscular dysplasia. Curr Opin Rheumatol 12:41–47

    Article  Google Scholar 

  4. Burke AP, Subramanian R, Smialek J, Virmani R (1993) Nonatherosclerotic narrowing of the atrioventricular node artery and sudden death. J Am Coll Cardiol 21:117–122

    Article  PubMed  CAS  Google Scholar 

  5. Cohle SD, Lie JT (1998) Histopathologic spectrum of the cardiac conducting tissue in traumatic and noncardiac sudden death patients under 30 years of age: an analysis of 100 cases. Anat Pathol 3:53–76

    PubMed  CAS  Google Scholar 

  6. Cohle SD, Paz Suarez-Mier M, Aguilera B (2002) Sudden death from lesions of the cardiac conduction system. Am J Forensic Med Pathol 23:83–89

    Article  PubMed  Google Scholar 

  7. Crocker DW (1968) Fibromuscular dysplasia of renal artery. Arch Pathol 85:602

    PubMed  CAS  Google Scholar 

  8. Harrison EG, McCormack LJ (1971) Pathological classification of renal arterial disease in renovascular hypertension. Mayo Clin Proc 46:161–167

    PubMed  Google Scholar 

  9. Hey A (1980) Seltene Komplikation einer fibromuskulären Dysplasie der Arteria carotis interna. Dtsch Med Wochenschr 105:1654–1658

    Article  PubMed  CAS  Google Scholar 

  10. Hill LD, Antonius JL (1965) Arterial dysplasia. An important surgical lesion. Arch Surg 90:585–595

    PubMed  CAS  Google Scholar 

  11. Hudson RE (1963) The human conducting-system and its examination. J Clin Pathol 16:492–498

    Article  PubMed  CAS  Google Scholar 

  12. Hunt JC, Harrison EG, Sheps SG et al (1965) Hypertension caused by fibromuscular dysplasia of renal arteries. Postgrad Med 38:53–58

    PubMed  CAS  Google Scholar 

  13. James TN (1967) Congenital deafness and cardiac arrhythmias. Am J Cardiol 19:627–630

    Article  PubMed  CAS  Google Scholar 

  14. James TN (1990) Morphologic characteristics and functional significance of focal fibromuscular dysplasia of small coronary arteries. Am J Cardiol 65:12G–22G

    Article  PubMed  CAS  Google Scholar 

  15. James TN, Armstrong RS, Silverman J, Marshall TK (1974) De subitaneis mortibus, VI: two young soldiers. Circulation 49:1239–1246

    PubMed  CAS  Google Scholar 

  16. James TN, Froggatt P, Marshall TK (1967) Sudden death in young athletes. Ann Intern Med 67:1013–1021

    PubMed  CAS  Google Scholar 

  17. James TN, Posada-de la Paz M, Abaitua-Borda I et al (1991) Histologic abnormalities of large and small coronary arteries, neural structures, and the conduction system of the heart found in post-mortem studies of individuals dying from the toxic oil syndrome. Am Heart J 121:803–815

    Article  PubMed  CAS  Google Scholar 

  18. Jing HL, Hu BJ (1997) Sudden death caused by stricture of the sinus node artery. Am J Forensic Med Pathol 18:360–362

    Article  PubMed  CAS  Google Scholar 

  19. Leadbetter WF, Burkland CE (1938) Hypertension in unilateral renal disease. J Urol 39:611–615

    Google Scholar 

  20. Letsch R, Kantartzis M, Sommer T, Garcia M (1980) Arterial fibromuscular dysplasia. Report of a case with involvement of the aorta and review of the literature. Thorac Cardiovasc Surg 28:206–210

    Article  PubMed  CAS  Google Scholar 

  21. Lüders H (1990) Sudden death due to fibromuscuar dysplasia of coronary arteries. Zentralbl Allg Pathol Pathol Anat 136:711–714

    Google Scholar 

  22. McCormack LJ, Hazard JB, Poutasse EF (1958) Obstructive lesions of renal artery associated with remediable hypertension. Am J Pathol 34:582–586

    Google Scholar 

  23. Mettinger KL, Ericson K (1982) Fibromuscular dysplasia and the brain. I. Observation on angiographic, clinical and genetic characteristics. Stroke 13:46–52

    Article  PubMed  CAS  Google Scholar 

  24. Meyer R (1999) Blut- und Lymphgefäße. In: Remmele W (Hrsg) Pathologie, Bd 1, 2. Aufl. Springer, Berlin Heidelberg New York Tokio, S 283

  25. Michaud K, Romain N, Brandt-Casadevall C, Mangin P (2001) Sudden death related to small coronary artery disease. Am J Forensic Med Pathol 22:225–227

    Article  PubMed  CAS  Google Scholar 

  26. Nerantzis CE, Koulouris SN, Marianou SK et al (2011) Histological findings of the sinus node and the perinodal area in street heroin addicts, victims of sudden unexpected death. J Forensic Sci 56:645–648

    Article  PubMed  Google Scholar 

  27. Palubinskas AJ, Ripley HR (1946) Fibromuscular hyperplasia in extrarenal arteries. Radiology 82:451–455

    Google Scholar 

  28. Perry MO (1974) Fibromuscular dysplasia. Surg Gynecol Obstet 139:97–104

    PubMed  CAS  Google Scholar 

  29. Schilling H (2009) Pathomorphologische Befunde im Erregungsbildungs- und -leitungssystem: Indikatoren für einen rhythmogenen Herztod. Medizinische Dissertation, Universität, Rostock

  30. Slovut DP, Olin JW (2004) Fibromuscular dysplasia. N Engl J Med 350:1862–1871

    Article  PubMed  CAS  Google Scholar 

  31. Strian F, Backmund H (1972) Fibromuskuläre Dysplasie der Carotiden. Nervenarzt 43:557

    PubMed  CAS  Google Scholar 

  32. Virmani R, Burke A, Farb A (1996) Atlas of cardiovascular pathology. Saunders, Philadelphia, S 184–186

  33. Vuong PN, Berry C (2002) The pathology of vessels. Springer, Berlin Heidelberg New York Tokio, S 91–117

  34. Weissleder R, Rieumont MJ, Wittenberg J (2003) Kompendium der bildgebenden Diagnostik. Springer, Wien

  35. Wilms GE, Smits J, Baert AL, DeWolf L (1985) Percutaneous transluminal angioplasty in fibromuscular dysplasia of the internal carotid artery: one year clinical and morphological follow-up. Cardiovasc Intervent Radiol 8:20–23

    Article  PubMed  CAS  Google Scholar 

  36. Zack F, Terpe H, Hammer U, Wegener R (1996) Fibromuscular dysplasia of coronary arteries as a rare cause of death. Int J Legal Med 108:215–218

    Article  PubMed  CAS  Google Scholar 

  37. Zack F, Rummel J (2008) Plötzlicher Tod bei sexueller Aktivität – eine Kasuistik. Rechtsmedizin 18:257–259

    Article  Google Scholar 

  38. Zack F, Rummel J, Weirich V, Wegener R (2005) Die fibromuskuläre Dysplasie der Sinus- und/oder der AV-Knotenarterie – eine seltene Todesursache? Rechtsmedizin 15:294

    Google Scholar 

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  1. Institut für Rechtsmedizin, Universitätsklinikum Rostock, St.-Georg-Str. 108, 18055, Rostock, Deutschland

    F. Zack, J. Rummel & A. Büttner

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  1. F. Zack
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  2. J. Rummel
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Correspondence to F. Zack.

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Zack, F., Rummel, J. & Büttner, A. Fibromuskuläre Dysplasie und akuter Herztod. Rechtsmedizin 21, 513–517 (2011). https://doi.org/10.1007/s00194-011-0784-7

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