U.S. flag

An official website of the United States government, Department of Justice.

NCJRS Virtual Library

The Virtual Library houses over 235,000 criminal justice resources, including all known OJP works.
Click here to search the NCJRS Virtual Library

Histologic Findings of the Sinus Node and the Perinodal Area in Street Heroin Addicts, Victims of Sudden Unexpected Death

NCJ Number
Journal of Forensic Sciences Volume: 56 Issue: 3 Dated: May 2011 Pages: 645-648
Christos E. Nerantzis, M.D., Ph.D.; Spyridon N. Koulouris, M.D., Ph.D.; Soultana K. Marianou, M.D.; Socrates C. Pastromas, M.D.; Philipos N. Koutsaftis, M.D.; Emmanuel B. Agapitos, M.D., Ph.D.
Date Published
May 2011
4 pages
Sudden unexpected death is frequent in street heroin addicts. This histologic study of the sinus node (SN) offers some evidence about the possible arrhythmogenic cause of death.
Postmortem coronary angiography and microscopic examination of the SN and the perinodal area were performed in 50 heroin addicts (group 1) and in 50 nonaddicts (group 2), all men (16-40 years old). In heroin addicts, fatty and/or fibrous tissue replaced SN tissue in 21 cases (42 percent). Perinodal infiltration was found in 15 cases (30 percent). Fibromuscular dysplasia in branches of the sinus node artery (SNA) was found in eight cases (16 percent). Inflammation with focal and/or diffuse concentration of round cells was detected in the SN in 22 cases (44 percent). Old mural thrombi were also found in 13 cases (26 percent). The histologic changes in the SN and perinodal area offer an explanation about the possible mechanism of arrhythmia and sudden death in this population. (Published Abstract)