Cuad Med Forense 2009; 15(55):7-16
Gu�as para la pr�ctica de la autopsia en casos de muerte s�bita card�aca.
Guidelines for autopsy investigation of sudden cardiac death.
C. Basso, M. Burke, P. Fornes, P. J. Gallagher, R. H. de Gouveia, M. Sheppard, G. Thiene y A. van der Wal en nombre de la Asociaci�n Europea de Patolog�a Cardiovascular. (http://anpat.unipd.it/aecvp/)
C. Basso * G. Thiene
Pathological Anatomy. Department of Medical Diagnostic Sciences and Special Therapies. University of Padua Medical School. Padua, Italy.
e-mail: [email protected] * e-mail: [email protected]
M. Burke
Department of Histopathology. Royal Brompton & Harefield NHS Trust. Harefield Hospital. Harefield, UK.
e-mail: [email protected].
P. Fornes
Department of Pathology. Hopital Europ�en G. Pompidou. Paris, France.
e-mail: [email protected]
P. J. Gallagher
Department of Pathology. Southampton University Hospital. Southampton, UK.
e-mail: [email protected]
R. H. de Gouveia
Department of Pathology. Hospital de Santa Cruz. Lisbon, Portugal.
e-mail: [email protected]
M. Sheppard
Department of Pathology. Royal Brompton Hospital. London, UK.
e-mail: [email protected]
A. van der Wal
Pathology. Academic Medical Center. University of Amsterdam. Amsterdam, The Netherlands.
e-mail: [email protected]
RESUMEN
A pesar de que la muerte s�bita card�aca es una de las formas m�s importantes de muerte en los pa�ses occidentales, este problema no ha recibido la atenci�n que merece por parte de los pat�logos y de los m�dicos de los sistemas p�blicos de salud. Se han desarrollado nuevos m�todos de prevenci�n de arritmias potencialmente mortales, y el diagn�stico de certeza de las causas de muerte s�bita card�aca es en este momento de particular importancia. Los pat�logos son responsables de determinar la causa exacta de la muerte s�bita pero existen diferencias considerables en el modo en el que se aborda esta cada vez m�s compleja tarea. La Asociaci�n Europea de Patolog�a Cardiovascular desarroll� unas gu�as que representan el est�ndar m�nimo necesario en la pr�ctica habitual de la autopsia para la valoraci�n de la muerte s�bita card�aca, incluyendo no s�lo un protocolo para el examen del coraz�n y el muestreo histopatol�gico, sino tambi�n para la investigaci�n toxicol�gica y molecular. Nuestras recomendaciones son aplicables a centros m�dicos universitarios, a hospitales regionales y locales y a todo tipo de Institutos de Medicina Forense. La adopci�n a lo largo de la Uni�n Europea de un m�todo uniforme de investigaci�n supondr� la mejora de la pr�ctica habitual, permitir� realizar comparaciones significativas entre distintas comunidades y regiones y, lo que es m�s importante a�n, favorecer� que se monitoricen los patrones de las enfermedades que causan una muerte s�bita.
Palabras clave: Autopsia. Gu�as. Protocolo. Muerte s�bita card�aca.
ABSTRACT
Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of the causes of sudden cardiac death is now of particular importance. Pathologists are responsible for determining the precise cause of sudden death but there is considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology developed guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate assessment of sudden cardiac death, including not only a protocol for heart examination and histological sampling, but also for toxicology and molecular investigation. Our recommendations apply to university medical centres, regional and district hospitals and all types of forensic medicine institutes. If a uniform method of investigation is adopted throughout the European Union, this will lead to improvements in standards of practice, allow meaningful comparisons between different communities and regions and, most importantly, permit future trends in the patterns of disease causing sudden death to be monitored.
Key words: Autopsy. Guidelines. Protocol. Sudden cardiac death.
Este art�culo es un reprint del original publicado en Virchows Arch (2008);452:11-18.
Traducido al castellano con el permiso de Springer-Verlag.
Traducci�n: Mar�a Santos y Joaqu�n Lucena. Instituto de Medicina Legal de Sevilla.
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