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Association of Right Coronary Artery Hypoplasia With Sudden Death in an Eleven-Year-Old Child

NCJ Number
131273
Journal
Journal of Forensic Sciences Volume: 36 Issue: 4 Dated: (July 1991) Pages: 1234-1239
Author(s)
R W Byard; N M Smith; A J Bourne
Date Published
1991
Length
6 pages
Annotation
This case report describes an unexpected death of an 11-year old boy in whom marked hypoplasia of the right coronary artery was found at autopsy, and who had experienced sudden collapse 8 months earlier.
Abstract
An apparently healthy boy suddenly lost consciousness while swimming in a public pool under the observation of a training instructor. Death was thought to be due to a sudden cardiac episode and not to drowning, because serial sectioning revealed a significant reduction in the luminal cross section of the proximal right coronary artery as compared with the left main anterior and posterior descending arteries. Most reported cases of congenital coronary artery abnormalities involve both an aberrant origin and course of the abnormal vessel. However, in this particular case, the coronary arteries were embedded in a moderate amount of epicardial fat and appeared externally unremarkable, following the normal distribution from their respective sinuses of Valsalva. A normal electrocardiography and negative family history made this diagnosis unlikely, particularly since his deafness was attributed to in utero exposure to rubella virus. Together with the previous episode of exercise-related collapse and the absence of other significant problems, the case suggests a cardiac problem. It demonstrates the importance of detailed transverse sectioning of all of the major coronary trunks at autopsy of sudden death in children. 2 figures and 16 references (Author abstract modified)

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