Spectrum of Aortic and Coronary Atherosclerosis: An Institutional Autopsy Study

Introduction: Cardiovascular diseases (CVDs) are major causes of mortality in Indian subcontinent. The burden of cardiovascular diseases is increasing rapidly in both rural as well as urban areas. It will soon emergedas largest disease accounting for more than one third of all deaths. Assessment of atherosclerotic lesions in living individuals is very difficult and non-existent due to invasive nature of disease and requirement of advanced set up. Therefore, autopsy-based study of coronary and aortic atherosclerosis is very useful tool to understand epidemiology and prevalence of the disease. Aims & Objectives: The main aim of the study is to estimate the prevalence of aortic and coronary atherosclerosis with their severity in tertiary care hospital and correlate it with associated histopathological findings. Material & Method: This study was conducted from January 2022 to December 2022 at department of pathology at the tertiary care centre in saurashtra region. Total 178 autopsies were received in a period of one year, out of which 175 autopsies contained heart as specimen. The request form contained previous history and probable cause of death along with specimen details. After the fixation and gross dissection of heart specimen tissue were processed and all the histopathological sections were examined under microscope and categorise for atheroma according to grading by American heart association (AHA). Results: Out of 175 patients, 26 (14.9 %) had associated cardiac disease or history of CVD and rest 149 (85.1%) had no any associated cardiac history. The age range was 10 years to 87 years including 61 (34.8%) females and 114(65.2%) males. In total 114 males, coronary atherosclerosis was found to be in 99patients and in 61 female patients, 40 cases of females were having coronary atherosclerosis. Out of 139 cases of atherosclerosis, incidence of involvement of aorta was observed as 58.9% cases in our study with 51.4%, 71.2% and 61.7% involvement of right coronary arteries, left anterior descending arteries and left circumflex arteries, respectively. Incidence of single vessel involvement were in 17 % cases, 28 % cases of double vessel involvement and 55% cases of triple vessel involvement with 12.6% severe atherosclerotic lesions in all three vessels were noted. Eighteen (12.9%) cases showed healed infarct, 11 (7.8%) cases showed acute myocardial infarction in walls of heart and 1 (0.7%)case of myocarditis was seen.Conclusion:The study showed high prevalence of atherosclerosis inthe 4th decade of life with male preponderance. Higher incidents of atherosclerosis in younger population gives an indication to take appropriate measures along with life style modification to prevent the cardiovascular diseases such as myocardial infarction and heart failure.