21. 22. 23. 24. Whether is it possible to have no signi icant autopsy indings in a patient died due to heart attack? In some individuals chest pain (angina) coupled with symptoms consistent with development of an acute myocardial infarction occurs immediately prior to sudden collapse and death. At autopsy, however there is no infarct and the coronary arteries are found to be patent without signi icant atherosclerosis or congenital anomalies. The death is believed to be due to transitory coronary artery spasm. What is the most common cause of sudden cardiac death in young adults? Hypertrophic cardiomyopathy is one of the most common cause of sudden otherwise unexplained death in young adults. Many patients may remain stable over many years of observations and some may improve. Most of such cases may be genetic in origin. Whether after having clear history of hypertension and medications at the time of entry in the jail and thereafter nonrecording of blood pressure or not seeking to con irm the diagnosis amounts to provision of inadequate patient care, if the person subsequently dies due to cerebrovascular accident (CVA)? Yes. Despite having clear history of hypertension and medications at the time of entry in the jail, non-recording of blood pressure or not seeking to con irm the diagnosis, when the patient is in custody; is suggestive of inadequate patient care. CVA is commonly due to thrombotic occlusion consequent to atherosclerosis or due to bleeding in brain. CVA has frequent association with systemic diseases such as hypertension and diabetes and is their direct known complication. Whether abnormally enlarged heart due to HCM can remain asymptomatic for long time and could suddenly cause death? The clinical spectrum of hypertrophic cardiomyopathy (HCM) is complex and includes a variety of disease pattern, which leads to different types of manifestations. Although most of the patients are asymptomatic, a signi icant proportion of them will develop symptoms MEDICAL DIMENSION OF FREQUENTLY ENCOUNTERED CASES | 36

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