(4) POST MORTEM STUDY OF HEART IN CASES OF SUDDEN CARDIAC DEATH USING TRIPHENYL TETRAZOLIUM CHLORIDE AND HAEMATOXYLIN & EOSIN STAIN

Background: Myocardial infarction (MI) is the most common cause of death for which the largest number of autopsies are done. Aims: A clinical study was done to determine those cases numerically smaller but medico-legally more important in which some unnatural event like a road accident, is suspected to die due to acute myocardial infarction. The likelihood of identifying an early infarct minimizes false positivity in cases of sudden death. Materials and Methods: A histochemical study on 100 hearts was carried out with using haematoxylin & eosin as a routine stain and Triphenyl tetrazolium chloride as gross marker, the latter can detect infarcts of less than 6 hours of age which help to assess the actual age of the infarct and confirmation of myocardial infarction as the cause of demise. Results: 68% of cases showed positive result with TTC staining while only 25 % of cases showed positive result with H & E stain. 75% of cases showed the age of infarction within 5 to 8 hours which made possible to detect early infarction by TTC staining. In 82.3% of cases gross examination did not reveal any evidence of infarction, but were revealed by TTC staining. Conclusion: Triphenyl tetrazolium chloride is the detector of earliest changes of infarction in comparison to gross and microscopic changes in the infracted heart.