Abstract: It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography （PMCT）. This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification （CAC） was clearly displayed using PMCT scan. The entire coronary artery system was almost reconstructed via multiplanar reformation （MPR） and volume-rendering reconstruction （VR）, and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software. The results showed that CAC was conspicuous; the total calcium score was 640.3, considerably higher than 400. The pulmonary ground-glass opacity（GGO） and small amount of fluid both in the subglottic trachea and main bronchi were also found. The imaging results confirmed those of autopsy. In addition, the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

Key words: forensic pathology, tomography, spiral computed, autopsy, death, sudden, cardiac, coronary disease