JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES Identification of Myocardial Infarction in Human Autopsy Population Using TTC

Abstract: Myocardial infarction is the most common cause of sudden death. However the identification of myocardial infarcts at necropsy is difficult. Various methods are being used to detect it. It has been shown that the use of dyes such as nitroblue tetrazolium and 2,3,5 triphenyl tetrazolium chloride (TTC) that identify the dehydrogenase deficient infracted myocardium are largely used. But the studies have been conducted largely in animal models using these dyes. Establishing the utility of these enzyme histochemical tests at autopsy on human cadavers is the need of the hour. We studied the fourty hearts of sudden death cases staining them with TTC and thereafter confirming with histology to know the efficacy of TTC staining. Our results showed that this histochemical test is a reliable method of investigation in sudden death cases. Key words: Myocardial infarction, 2,3,5 tri phenyl tetrazolium chloride, histochemical tests. Introduction: Sudden unexpected deaths pose a serious problem not only to the family members but also to the treating physician if the person was admitted in the hospital for some other disease. Many a times its difficult to find out exact cause of death in such situations. Forensic pathologists along with criminal cases, deal with these sudden deaths in finding out the cause of death. According to WHO prediction, by AD 2020 up to three-quarters of death in developing countries would result from non-communicable diseases and that coronary heart disease will top the list of killers.[1] Coronary heart disease otherwise called as Myocardial Infarction (MI) is a dreaded complication of coronary atherosclerosis. The diagnosis of MI in living is attainable whereas in dead or sudden death cases, its diagnosis is difficult. Various biochemical tests have been used at autopsy to diagnose MI, by using dyes such as nitroblue tetrazolium (NBT) and 2,3,5 triphenyl tetrazolium chloride (TTC), that identify the dehydrogenase-deficient infarcted myocardium[2]. Various studies have been conducted both in animals and human hearts to know the effectiveness of the histochemical methods and also to detect the extent of myocardial infarction. Carlos et al. studied a comparison of infarct identification with Technetium 99m