Unexpected sudden death secondary to atrial epicarditis involving the sinoatrial node

J. Y. Na

Abstract: Myocarditis can cause sudden death by precipitating arrhythmia and acute heart failure; however, chronic epicarditis is usually not a fatal condition. Lymphocytic myocarditis is the most common histopathological subtype of myocarditis. Lymphocytic infiltration in the ventricle is usually focal or diffuse in nature; however, atrial infiltration is rare. Notably, atrial myocarditis can be fatal, particularly, in patients in whom lymphocytic infiltration involves nodal tissue, with consequent arrhythmia. A 51-year-old woman was discovered dead on the toilet seat at her home. The autopsy and postmortem laboratory investigations revealed atrial epicarditis involving the sinoatrial node and microscopic examination with immunohistochemical staining revealed T-lymphocyte infiltration of the atria. The author reports a case of a woman who died of atrial lymphocytic epicarditis involving the sinoatrial node.
Keywords: sudden cardiac death, sinoatrial node, inflammation, forensic pathology.