2 CASES OF UNEXPECTED SUDDEN-DEATH DUE TO CYSTIC MEDIONECROSIS OF THEAORTA ASSOCIATED WITH BLOODLESS AORTIC DISSECTION

The autopsy findings from two rare cases of sudden death concerning a 31- and a 44-year-old woman are reported. Autopsy and morphological ex amination revealed a dissection of the aorta but no rupture into the p ericardial sac. In both cases mucoid deposits in all layers of the med ia and rarefication of the elastic fibers were found, rendering cystic medionecrosis as the cause of the aortic dissection. In these unusual cases, only a very small intimal tear was present, but no blood in th e dissected aortic wall. Evidence of left ventricular hypertrophy and a history of hypertension were reported in both cases. No extension of the aortic dissections into the left or right coronary artery and no other clinical or pathological findings associated with aortic dissect ion were present. Cystic medionecrosis was the cause of the aortic dis section in these cases. The mechanism of death in both cases is discus sed. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.