Morphological changes in coronary arteries in cases of sudden cardiac death at high altitude

ABSTRACT

To determine the changes in coronary arteries in patients dying at high altitude. Observational descriptive study was carried out at Armed Forces Institute of Pathology and Army Medical College Pathology Laboratory, Rawalpindi form 2002 to 2004 on autopsy of 58 cases dying at high altitude. In 53 out of 58 cases, death was attributed to coronary atherosclerosis. The majority of cases were less than 40 years as also observed in people dying below high altitude. However triple vessel coronary atherosclerosis was seen in 67% cases and left anterior descending coronary artery was involved in almost 100% cases. Coronary atherosclerosis remains the major cause of death at high altitude in acclimatized individuals. Accelerated coronary atherosclerosis with triple vessel involvement in patients without prior history of ischemic heart disease points to specific indicators. Dietary modifications with high carbohydrate diet are recommended at high altitudes