Cardiac sudden death as a result of acute coronary artery thrombosis during chemotherapy for testicular carcinoma

Journal of Forensic Sciences
Michael PanellaAlex Martin

Abstract

We report the first acute coronary fibrin thrombus arising upon atherosclerosis detected at autopsy in a man receiving chemotherapy for testicular carcinoma. The decedent was a smoker with no other known atherosclerotic risk factors. Histology revealed superficial atherosclerotic plaque erosion with endothelial necrosis and no intraplaque hemorrhage. A focus of intimal lymphoid infiltrates was noted away from the plaque. These findings raise the possibility of chemotherapy-induced vascular damage as a factor in thrombogenesis. A review of Pubmed was performed which documented clinical reports of an association of chemotherapy with acute cardiac ischemia but no well described autopsy findings. Our case highlights the need for careful assessment of the coronary system in chemotherapy patients dying suddenly, particularly in the absence of significant atherosclerotic risk factors. Such postmortem examination will ensure thorough death investigation and may elucidate the pathogenesis of thrombosis with potential reduction in cardiac ischemic risks of chemotherapy patients.

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Citations

Jan 13, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Cezar A IliescuKonstantinos Marmagkiolis
Apr 23, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·C Kollmannsberger, C Nichols
Jun 3, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christian K Kollmannsberger, Craig R Nichols
Mar 30, 2016·Circulation·Joerg HerrmannKonstantinos Marmagkiolis
Mar 23, 2021·BMC Cancer·Yannan WangFeiya Zhu

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