Forensic medical characterization of sudden death in young people with connective tissue dysplasia according to the data of the Bureau of Medical Examinations of Moscow City

Abstract

BACKGROUND: Sudden death is an urgent problem of modern public healthcare, with prevalence in the Russian Federation. The wide range of causes and data scarcity led to the complexity of diagnosis and interpretation of pathologic changes at autopsy. This study presents an epidemiologic analysis of the causes of sudden death in a young population. AIM: To provide a forensic medical description of cases of sudden death of young people with connective tissue dysplasia using data from forensic autopsies conducted at the Bureau of Medical Examinations of the Moscow City Health Department. MATERIALS AND METHODS: A sample study of 48 corpses of young people aged 18–44 years who died suddenly, was performed based on data from the Forensic Medical Examination Bureau of the Moscow Department of Health. The protocols for examining the corpse at the scene of the incident, medical records were analyzed comprehensively. An extended description of the external and internal examinations of corpses was performed, and materials for histological, histochemical, and immunohistochemical studies were collected. RESULTS: Cardiovascular pathologies were the main cause of sudden death in young people. In some cases, an asthenic type was established with the following signs: high stature, elongated chest with an acute epigastric angle, poorly defined subcutaneous fatty tissue, weight less than the age norm, and narrow shoulders. Pathological changes were identified in the sternum, spine, limbs, dental status, and internal organs, which corresponded to connective tissue dysplasia. A correlation was noted between sudden death in young people and asthenic skeletopathy with exposure to extreme factors such as physical stress, psychoemotional stress, and previous infectious diseases. In most cases of sudden death, pathological changes in blood vessels were diagnosed in young people. CONCLUSION: The development of a modern comprehensive scientific and methodological approach is necessary to assess pathomorphological changes in young people who died suddenly.