Histological and Morphometric Analysis with Grading of Atherosclerosis-Associated Myocardial Changes in Cases of Sudden Death at a Tertiary Care Hospital

Background: Sudden cardiac death (SCD) remains a significant public health concern worldwide, representing a considerable proportion of mortality linked to cardiovascular diseases. Atherosclerosis, a progressive disease characterized by the accumulation of lipids, fibrous elements, and inflammatory cells within the arterial walls, is a leading underlying cause of SCD. Methodology: An observational study was conducted focusing on histology, morphometric analysis, and grading of atherosclerosis-associated myocardial findings in cases of sudden death in 194 cases over a period of 18 months in the Department of Pathology, SMIMER Medical College, Surat. Results: The study involved 194 participants, with a notable gender imbalance favouring males, who represented 89.7% of the cohort. There was a clear trend of increasing coronary artery grade with advancing age. Ischemic Heart Disease (IHD) was the most prevalent myocardial finding, observed in 54.6% of the cases. 148 (76%) cases showed both the coronary involvement in patients with Ischaemic Heart Disease. For Ischemic Heart Disease (IHD), the AHA grades are predominantly VII (47.2%), V (21.7%), and VI (17.0%). As the coronary artery grade increases, there is a notable rise in both ITI and IMR values. Conclusion: In conclusion, this study demonstrates that a comprehensive evaluation combining histological grading and morphometric analysis is crucial for a thorough understanding of atherosclerosis-related myocardial changes.