...The book is richly illustrated by more than 150 color photographs that demonstrate forensic aspects of cardiopathology. I would highly recommend it for all forensic pathologists, especially as it offers a single source of pertinent information that is essential for every forensic pathologist to have when investigating a cardiovascular deaths...
Pathology of the Heart and Sudden Death in Forensic Medicine, 1st Ed, by Vittorio Fineschi, Giorgio Baroldi and Malcolm D. Silver. Hard Bound, 7" x 1.1" x 10”.
CRC Press LLC, 2000 Corporate Blvd., N.W., Boca Raton, Florida 33431, Phone - 1(800)272-7737, Fax - 1(800)374-3401. Publication Date May 22, 2006. 519 pages, ISBN-10: 0849370485; ISBN-13: 978-0849370489 (alk. paper). Price: $149.35.
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The book under review addresses the pathology of the heart and cardiovascular system from a forensic perspective, an aspect not dealt with exclusively in a book. All of us encounter a number of deaths related to CVS causes, and we all needed a comprehensive single source where we could get all our information from. Fineschi and colleagues achieve this task in an excellent manner.
The book begins by describing the basic functional anatomy of the heart, combining views on examination from clinical and pathological perspectives. It then goes on to systematically examine patho-physiologic changes and specific heart diseases and emphasizes the benefits of communication between forensic specialists and clinicians in determining cause of death.
The book critically reviews pertinent facts, revisits pathologic findings and compares them to etiopathology. It even proposes new etiopathologies substantiated by previously misinterpreted or ignored facts. Recent findings on pediatric pathology are also presented.
First four chapters are important as they deal with basic medical sciences in relation to forensic medicine. After a brief introduction in chapter 1, the authors go on to discuss the functional anatomy of the heart in chapter 2, Examination of the heart in chapter 3 and basic pathophysiological changes in chapter 4. There is a discussion of extramural and intramural coronary arteries and their preponderance, which is very useful in understanding the pathology of the heart.
Chapter 5 is a very important chapter which deals with specific heart diseases and sudden death. A thorough discussion of several conditions appear here - among them unstable angina, chronic coronary heart disease, myocarditis and cardiomyopathies of unknown nature. An especially interesting section is on "orthotopic transplanted human heart", where the author discusses pathological lesions in transplanted hearts. There is a histopathological picture on page 135, which shows massive acute rejection in one of such transplanted hearts.
A particularly useful chapter is on channelopathies [chapter 9], where the authors discuss several disorders of the ion channels namely Long QT syndrome [LQTS], Brugada Syndrome [BS], catecholaminergic polymorphic ventricular tachycardia [CPMVT or Ryanodine receptor defect] and Short QT Syndrome [SQTS].
Chapter 12 deals with CVS trauma. It is well known that thoracic traumas are of great importance, second only to craniocerebral trauma as a cause of morbidity and mortality. About one-fourths of all traumatic deaths are due to thoracic injuries. The chapter gives mechanisms of injuries and pathological pictures of non-penetrating trauma, penetrating trauma and iatrogenic traumas. I found this chapter very informative and useful.
Chapter 13 entitled "cardiac surgery and forensic medicine" deals mostly with surgeries that are carried out on heart. One learns, for example, about several myocardial revascularization methods - venous grafts, internal thoracic [mammary artery graft], radial artery graft, gastroepiploic artery graft etc. This is necessary for forensic pathologists to know when encountering deaths of persons having undergone cardiac surgery.
Chapter 14 deals with a rarely discussed subject - Drugs of abuse and pathology of the heart. Effect of cannabis on 5 drugs of abuse is discussed - cocaine, MDMA and MDEA, narcotic agents, androgenic anabolic steroids and cannabis and its analogues. I particularly enjoyed reading the effects of cannabis on heart; this information is rarely found elsewhere.
A unique aspect of the book is that it assists the forensic pathologist in the presentation and interpretation of the sequence of events in a court of law. Overall a very useful book, which deals with all forensic aspects of heart.
The book is richly illustrated by more than 150 color photographs that demonstrate forensic aspects of cardiopathology. I would highly recommend it for all forensic pathologists, especially as it offers a single source of pertinent information that is essential for every forensic pathologist to have when investigating a cardiovascular deaths.
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