Histopathological Spectrum of Cardiac Lesions in Sudden Death: An Autopsy-Based Study from the Mahakaushal Region of Central India

Abstract

Background: Sudden cardiac death (SCD) is a major global public health problem and constitutes a large proportion of medicolegal autopsies. In India, data from semi-rural regions remain limited, and many cardiovascular pathologies go undiagnosed during life. Objectives: To evaluate the histopathological spectrum of cardiac lesions in sudden deaths, assess age- and sex-wise distribution, and correlate gross and microscopic cardiac findings. Methods: This autopsy-based observational study was conducted on sudden death cases received at a tertiary care center in the Mahakaushal region of Madhya Pradesh, India. Hearts were examined grossly and sampled systematically from the left ventricle, interventricular septum, right ventricle, and coronary arteries. Histopathological evaluation was performed using hematoxylin and eosin staining. Results: Cardiovascular pathology was identified in the majority of sudden deaths, with ischemic heart disease and coronary atherosclerosis being the predominant findings. The left anterior descending artery was most frequently involved. Acute myocardial infarction showed coagulative necrosis, wavy fibers, edema, and neutrophilic infiltration, while chronic ischemic injury was characterized by fibrosis and collagen scar formation. Males in the 41–60-year age group were most commonly affected. Gross findings such as cardiomegaly, left ventricular hypertrophy, and coronary stenosis showed strong correlation with histopathological abnormalities. Conclusion: Coronary atherosclerosis and myocardial ischemic injury are the leading histopathological substrates of sudden cardiac death in the Mahakaushal region. Autopsy with detailed microscopic examination remains indispensable for accurate cause-of-death determination and for identifying silent cardiovascular disease in the community.