Isolated Atrial Neutrophilic Myocarditis
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Isolated Atrial Neutrophilic Myocarditis : A Rare Cause of Death and Potential "Blind Spot" for Postmortem Computed Tomography and Postmortem Examination. / Duffy, Michael; O'Connor, Kate; Milne, David; Ondruschka, Benjamin; Tse, Rexson; Garland, Jack.
In: AM J FOREN MED PATH, Vol. 43, No. 1, 01.03.2022, p. 73-75.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Isolated Atrial Neutrophilic Myocarditis
T2 - A Rare Cause of Death and Potential "Blind Spot" for Postmortem Computed Tomography and Postmortem Examination
AU - Duffy, Michael
AU - O'Connor, Kate
AU - Milne, David
AU - Ondruschka, Benjamin
AU - Tse, Rexson
AU - Garland, Jack
N1 - Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Myocarditis can focally or diffusely involve the myocardium and is associated with arrhythmia, cardiac failure, and sudden death. The majority of cases of myocarditis are lymphocytic in etiology, and neutrophilic myocarditis is relatively uncommon. Although reported in lymphocytic myocarditis, isolated/focal neutrophilic myocarditis of the atrium causing death is not reported in the postmortem literature, and its postmortem computed tomography correlation is not documented. We report a fatal case of isolated neutrophilic atrial myocarditis affecting only the left atrium in a 33-year-old woman presenting as a sudden unexpected death. Microscopy of the left atrium, a not commonly sampled area of the heart, showed florid neutrophilic myocarditis with the remaining right atrium, conduction system, and both ventricles uninvolved. Similar to previously reported fatal isolated atrial lymphocytic myocarditis, postmortem computed tomography was unable to detect any atrial abnormalities. This case highlights a potential "blind spot" for both routine postmortem imaging and examination.
AB - Myocarditis can focally or diffusely involve the myocardium and is associated with arrhythmia, cardiac failure, and sudden death. The majority of cases of myocarditis are lymphocytic in etiology, and neutrophilic myocarditis is relatively uncommon. Although reported in lymphocytic myocarditis, isolated/focal neutrophilic myocarditis of the atrium causing death is not reported in the postmortem literature, and its postmortem computed tomography correlation is not documented. We report a fatal case of isolated neutrophilic atrial myocarditis affecting only the left atrium in a 33-year-old woman presenting as a sudden unexpected death. Microscopy of the left atrium, a not commonly sampled area of the heart, showed florid neutrophilic myocarditis with the remaining right atrium, conduction system, and both ventricles uninvolved. Similar to previously reported fatal isolated atrial lymphocytic myocarditis, postmortem computed tomography was unable to detect any atrial abnormalities. This case highlights a potential "blind spot" for both routine postmortem imaging and examination.
KW - Adult
KW - Autopsy
KW - Cause of Death
KW - Female
KW - Heart Atria/diagnostic imaging
KW - Humans
KW - Myocarditis/diagnostic imaging
KW - Myocardium
KW - Tomography, X-Ray Computed
U2 - 10.1097/PAF.0000000000000684
DO - 10.1097/PAF.0000000000000684
M3 - SCORING: Journal article
C2 - 35113818
VL - 43
SP - 73
EP - 75
JO - AM J FOREN MED PATH
JF - AM J FOREN MED PATH
SN - 0195-7910
IS - 1
ER -