@article{3149459,
    title = "Histologic Findings of the Sinus Node and the Perinodal Area in Street
Heroin Addicts, Victims of Sudden Unexpected Death",
    author = "Nerantzis, Christos E. and Koulouris, Spyridon N. and Marianou, Soultana and K. and Pastromas, Socrates C. and Koutsaftis, Philipos N. and Agapitos, and Emmanuel B.",
    journal = "Journal of Forensic Sciences",
    year = "2011",
    volume = "56",
    number = "3",
    pages = "645-648",
    publisher = "Wiley-Blackwell",
    issn = "0022-1198, 1556-4029",
    doi = "10.1111/j.1556-4029.2011.01717.x",
    keywords = "forensic science; heart; atria blood supply; sinus node; heroin; heroin
addicts; sudden death",
    abstract = "Sudden unexpected death is frequent in street heroin addicts. We
conducted a histologic study of the sinus node (SN) to offer some
evidence about the possible arrhythmogenic cause of death. Postmortem
coronary angiography and microscopic examination of the SN and the
perinodal area were performed in 50 heroin addicts (group 1) and in 50
nonaddicts (group 2), all men (16-40 years old). In heroin addicts,
fatty and/or fibrous tissue replaced SN tissue in 21 cases (42%).
Perinodal infiltration was found in 15 cases (30%). Fibromuscular
dysplasia in branches of the sinus node artery (SNA) was found in eight
cases (16%). Inflammation with focal and/or diffuse concentration of
round cells was detected in the SN in 22 cases (44%). Old mural thrombi
were also found in 13 cases (26%). The histologic changes in the SN and
perinodal area offer an explanation about the possible mechanism of
arrhythmia and sudden death in this population."
}