Because of cardiac Raynaud's phenomenon, contraction band necrosis occurred which was due to ischaemia-reperfusion injury along with electrical impulse conduction pathway.
Contraction band necrosis can cause sinoatrial block, first degree AV nodal block, second degree heart block, right bundle branch block and left bundle branch block.
PubMed was searched using the MeSH terms forensic pathology, death, sudden, asphyxia, drowning, pulmonary surfactant-associated proteins, heat shock protein, and stress cardiomyopathy and the text terms in-custody, excited delirium, contraction band necrosis, and epilepsy.
The histological finding of contraction band necrosis (CBN) has been associated with myocardial cell injury and death, particularly related to exposure to high levels of catecholamines (endogenous or exogenous) and transient ischemia with subsequent reperfusion.
Sarcoplasmic fibrils and contraction band
necrosis were studied with a peroxidase technique (Dako Envision Systems) using a desmin antibody (monoclonal anti-desmin II, 53-kDa desmin protein specificity; ICN Pharmaceuticals) (33) and with Heidenhain's iron hematoxylin, respectively (33,34).
A classic pathologic feature most commonly observed in the heart exposed to toxic effects of catecholamines is myocardial contraction band
External to the infarct necrosis was a large layer of contraction band
necrosis formed by hypercontracted, deeply eosinophilic myocardial cells with rupture of the myofibrillar apparatus in anomalous bands, with no macrophagic reaction (Figure).
Morphological criteria were used to assess histopathological damage: 0, no damage; 1 (mild), interstitial edema and focal necrosis; 2 (moderate), diffuse myocardial cell swelling and necrosis; 3 (severe), necrosis with contraction bands
, neutrophil infiltration, and compression of capillaries; 4 (very severe), widespread necrosis with contraction bands
, neutrophil infiltration, capillary compression and hemorrhage.
Histological examination revealed a mixture of necroses and contraction bands
. Eber et al.
1998) were used to assess the histopathological damage: score 0, no damage; score 1 (mild), interstitial edema and focal necrosis; score 2 (moderate), diffuse myocardial cell swelling and necrosis; score 3 (severe), necrosis with the presence of contraction bands
, neutrophil infiltration and the capillaries were compressed; and score 4 (highly severe), widespread necrosis with the presence of contraction bands
, neutrophil infiltration, capillaries compressing and hemorrhage.
A total of 12 samples (22%; Table 3) showed only contraction bands
suggestive of very early ischemic changes of an undetermined age.
The cytoskeletal and contractile apparatus of smooth muscle: contraction bands
and segmentation of the contractile elements.