In order to clarify the effect of
trauma and treatment as stresses on myocardia, we examined histological changes of myocardia in victims who received various kinds of traumata and treatments. We also undertook a histochemical study for
calmodulin, which we found useful in the diagnosis of early
ischemia. Those who died shortly after
stab wounds, traffic accident or
head injuries, showed mild cardiac lesions such as contraction bands or fragmentation and mild diffusion of
calmodulin, a marker for
necrosis. A case with
hemorrhagic shock after a traffic accident, involving intense
resuscitation for 2 h, showed severe cardiac lesions such as contraction bands, hydropic change and subendocardial
hemorrhage along with severe diffusion of
calmodulin. In most of the instant death cases after falls, severe contraction band
necrosis and severe
calmodulin diffusion were observed. Myocardia of victims, who died several days after
head injuries or traffic accidents, generally demonstrated distinct diffusion of
calmodulin as compared to the mild and non-specific lesions detected by
hematoxylin-
eosin (H&E) staining. In cases of long-term survival in a state of
brain death,
calmodulin staining was very low, which was not always associated with the severity of the lesions on H&E staining. In cases with intensive or extended treatment, it appeared to be difficult to determine the cause-effect relationship between
trauma and cardiac lesions or to distinguish the lesions due to extrinsic factors from those of disease. In some cases,
calmodulin intensely stained the areas with hydropic appearance or
hypereosinophilia, which may be related to
calcium overload.