Coronary Sclerosis, Myocardial Infarction, Myocarditis, Cardiomyopathy, Coronary Anomalies, and the Cardiac Conduction System

  • Reinhard B. Dettmeyer


In forensic medicine, histopathologically detectable diseases that are able to explain sudden and unexpected death play a major role in the investigation of possible causes of death. Diseases of this kind primarily affect the heart: besides stenosing coronary atherosclerosis with coronary thrombosis, the detection of myocardial infarction, (mostly viral) myocarditis, anomalies of the coronary arteries and cardiac conduction system, as well as all forms of cardiomyopathy, warrant mention. Some diseases, such as myocarditis, can only be diagnosed histologically. Rare diseases are also seen, such as drug-induced toxic myocarditis, tuberculous myocarditis, fungal myocarditis, cardiac sarcoidosis, and rheumatic myocarditis. Determining the age of myocardial infarction is sometimes important, e.g., in the case of claims relating to missed myocardial infarction. Histopathology can also help to identify the type of disease from the broad spectrum of cardiomyopathies, enabling further investigations, such as genetic testing for cardiomyopathy, to be initiated where necessary. Findings in the cardiac conduction system and fibromuscular dysplasia of the atrioventricular node artery are discussed extremely rarely and, to an extent critically, as factors potentially relevant to cause death.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Reinhard B. Dettmeyer
    • 1
  1. 1.University Hospital Giessen Institute of Forensic MedicineGiessenGermany

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