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<p>Sudden unexpected death in childhood presents a profound challenge for health professionals and families. Pulmonary artery aneurysms (PAA) are among the rarest causes, typically leading to death through rupture. A rare case of sudden childhood death due by a non-ruptured PAA is reported, highlighting a previously unrecognized pathophysiological mechanism. A previously healthy 6-year-old girl collapsed suddenly three hours after vigorous physical activity. Resuscitation efforts failed, and she was declared dead on arrival at the hospital. A forensic autopsy revealed no signs of trauma on external examination. Internal examination identified a large, non-ruptured, true aneurysm of the pulmonary artery. Critically, the adjacent left ventricular wall exhibited extensive myocardial fibrosis. Histology confirmed the fibrotic aneurysm wall and the disruptive myocardial fibrosis. Toxicology analysis was negative. This case suggests a documented mechanism for sudden death from a non-ruptured PAA, likely via an arrhythmia triggered by exertion on a substrate of myocardial fibrosis, potentially exacerbated by the aneurysm’s mass effect.</p>

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Sudden death in a child due to a non-ruptured pulmonary artery aneurysm: a forensic case report

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Mariem Grayaa,
  • Taher Sakly,
  • Asma Ben Mabrouk,
  • Oumeima Bouzid,
  • Leila Njim,
  • Nidhal Haj Salem

摘要

Sudden unexpected death in childhood presents a profound challenge for health professionals and families. Pulmonary artery aneurysms (PAA) are among the rarest causes, typically leading to death through rupture. A rare case of sudden childhood death due by a non-ruptured PAA is reported, highlighting a previously unrecognized pathophysiological mechanism. A previously healthy 6-year-old girl collapsed suddenly three hours after vigorous physical activity. Resuscitation efforts failed, and she was declared dead on arrival at the hospital. A forensic autopsy revealed no signs of trauma on external examination. Internal examination identified a large, non-ruptured, true aneurysm of the pulmonary artery. Critically, the adjacent left ventricular wall exhibited extensive myocardial fibrosis. Histology confirmed the fibrotic aneurysm wall and the disruptive myocardial fibrosis. Toxicology analysis was negative. This case suggests a documented mechanism for sudden death from a non-ruptured PAA, likely via an arrhythmia triggered by exertion on a substrate of myocardial fibrosis, potentially exacerbated by the aneurysm’s mass effect.