Role of Triphenyl Tetrazolium Chloride to detect early myocardial ischemia in sudden death cases
Author(s): Alpesh B Bambhaniya, Mahesh M. Trangadia,, Mehul C Upadhyay, Rahul A Mehta, B D Gupta, Kalpesh R Chaudhari
Background: Coronary artery disease is the most frequent cause of sudden and unexpected deaths which constitute a significant portion of the autopsies that are conducted. In most of them we do not find any positive evidence of early infraction. So we cannot give cause of death in those cases.
Aims: To diagnose ischemic changes in heart of such cases of sudden deaths by TTC.
Materials & Methods: The present study was carried at the Department of Forensic Medicine Shri M. P. Shah Govt. Medical College, Jamnagar during the period of December 2010 to August 2012. In present study 130 sudden deaths cases were included. The heart was examined in these cases for gross [before and after Triphenyl Tetrazolium Chloride (TTC) test] and microscopic [Hematoxylin & Eosin (H&E)] staining for any changes of ischemia in relation to survival time.
Results: TTC test was positive in 26(20%) case out of which 12(46.6%) cases were only TTC positive and remaining 14 (53.8%) cases were positive for both TTC and H&E staining. Total H&E positive were 17(13%) cases out of which 3(17.6%) cases were showed H&E positive but TTC negative. 21cases (16.1%) showed ischemic changes by TTC those had postmortem interval <6hours, and no any case showed TTC positive which had postmortem interval >12 hrs.
Conclusion: An attempt should be made to establish TTC testing at all the hospitals where the postmortem examinations are conducted. The technique of TTC is quite simple and easy to perform and reasonably cheap.