Cardiac Multiple Micro-Scars: An Autopsy Study (JACC Case Reports March 2025)-Article: Cardiac Multiple Micro-Scars: An Autopsy Study

Article: Cardiac Multiple Micro-Scars: An Autopsy Study

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The document presents a clinical case series from an autopsy study investigating the presence of multiple micro-scars (MMS) in the myocardium of patients who died from unexplained cardiac arrests. These findings were observed in a pathology conference at a hospital over an eight-month period. Three patients, two women aged 75 and 91 and a man aged 73, exhibited MMS throughout their heart tissue, despite having different medical backgrounds and histories, including COVID-19 booster vaccinations. One of the patients had a COVID-19 infection history.<br /><br />The study's pathology results revealed that these MMS were found in various regions of the heart, including the left and right ventricles, atria, and at the juncture of the pulmonary vein with the left atrium. Intriguingly, the patients exhibited normal left ventricular ejection fractions, suggesting the scars might not have immediately impacted heart function. However, they experienced arrhythmias prior to their deaths.<br /><br />The novelty of the MMS finding, unrelated to myocardial infarction or common scarring seen via MRI, implies a potential new pathological entity, possibly linked to recent trends like the COVID-19 pandemic and vaccination dynamics. Microscopic examination suggested thrombotic microangiopathy—indicating microscopic blood clots—and highlighted unique scar distribution patterns in the myocardium, possibly due to inflammation at the capillary level.<br /><br />The study emphasizes the need for further investigations to understand the causative links, especially the potential associations between MMS and COVID-19 treatments or infections. The paper advocates for enhanced diagnostic capabilities, using imaging or blood tests, to preemptively identify MMS prior to fatal cardiac events. However, it remains cautious about definitively correlating these scars with COVID-19 vaccines or infections due to data limitations. The study urges more research into identifying and understanding MMS to improve medical outcomes.

Keywords

micro-scars

myocardium

unexplained cardiac arrests

autopsy study

COVID-19

thrombotic microangiopathy

arrhythmias

pathology

vaccination

inflammation