University of Rijeka. Faculty of Medicine. Department of Forensic Medicine and Criminalistics.
Abstract
Važnost kardiovaskularnih bolesti osim u ukupnom svjetskom morbiditetu i mortalitetu, očituje se i u ulozi KVB kao čimbenika prirodne, nagle i iznenadne smrti. KVB uzrok su nagle i iznenadne smrti u otprilike 50-60% slučajeva svih zabilježenih NS.
KVB u svom nazivu obuhvaćaju heterogenu skupinu bolesti srca i krvnih žila koje mogu prouzročiti NS, no najčešće su to upravo bolesti srca i koronarnih arterija s koronarnom aterosklerozom kao predvodnicom naglih srčanih smrti u oko 50-75% slučajeva. U manjem broju slučajeva uzrok NSS su kardiomiopatije (oko 15%), valvularne bolesti srca (oko 5%) i kanalopatije (oko 4-12%). Godišnje u svijetu umire oko 3.7 miljuna ljudi kao posljedica NSS, što iznosi oko 6% svjetskog mortaliteta.
U mehanizme koji dovode do NS ubrajaju se i krvnih žila, posebice bolesti aorte kao što su aneurizma i disekcija aorte. NS može nastupiti i u okviru ozljeda srca i krvožilnog sustava koje su se razvile kao posljedica traumatskih događaja, te ostalih rjeđih patoloških stanja KVS.
NS kao posljedica bolesti KVS može se utvrditi tek nakon provedene obdukcije, koju obavlja specijalist sudske medicine. Specijalist sudske medicine na temelju morfoloških nalaza, makroskopskih i mikroskopskih rezultata obdukcije utvrđuje čimbenike i mehanizme kojima su različita kardiovaskularna oboljenja dovela do naglog i iznenadnog smrtnog ishoda.Apart from its impact the overall global morbidity and mortality rate, the importance of cardiovascular diseases is seen in the role of CVD as a factor of sudden unexpected death. CVD are the cause of SUD in approximately 50 to 60% of all recorded cases.
CVD comprise a heterogeneous group of heart and blood vessel diseases, which can cause SUD. However, in the majority of cases, it is in fact heart and coronary artery diseases, with coronary atherosclerosis as the leading cause of sudden cardiac death in approximately 50 to 75% of cases. In a smaller number of cases, the causes of natural sudden death are cardiomyopathies (approx. 15%), valvular heart disease (approx. 5%), and channelopathies (approx. 4 to 12%). Annually, 3.7 million people die from natural sudden death, which accounts for 6% of the global mortality rate.
Vascular diseases also make part of the mechanisms which cause SUD, specifically diseases of the aorta, such as aortic aneurysm, and aortic dissection. SUD can also occur due to injuries of the heart and vascular system that were caused by traumatic events, as well as other, rarer pathological conditions of cardiovascular system.
SUD, as a consequence of diseases of the cardiovascular system, can be determined only after an autopsy, which is conducted by a forensic medicine specialist. Based on morphological findings, macroscopic and microscopic autopsy results, the forensic medicine specialist determines the factors and mechanisms of various CVD which led to the sudden death outcome
