Sudden cardiac death after robbery: Homicide or natural death?. (October 2020)

• Record Type: Journal Article
• Authors: Bottari, Giampiero; Trotta, Silvia; Marzullo, Andrea; Meliota, Giovanni; Ciccone, Marco Matteo; Solarino, Biagio
• Is Part Of: Journal of forensic and legal medicine. Volume 75(2020)
• Publication Date: 2020-10
• Subjects: Tako-tsubo -- Cardiomyopathy -- Robbery -- Autopsy -- Homicide; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Electronic journals; 614.1
• DOI: 10.1016/j.jflm.2020.102057
• Languages: English
• ISSNs: 1752-928X

Abstract

Abstract: Tako-Tsubo is one of a number of rare acquired cardiomyopathies that are characterized by left ventricular dyskinesia and symptomatology typical of acute myocardial infarction (AMI). The most important feature is that the clinical features are triggered by a severe physical or emotional stress. The authors describe the story of a woman, who was brutally assaulted by two men during a house robbery and died from sudden heart failure 8 hours later, after being taken to hospital. External examination revealed no macroscopic alteration of the inner organs, whereas microscopy showed contraction bands with myocardial necrosis, subendocardial and interstitial neutrophil infiltration and fibrosis. These findings were consistent with death due to stress cardiomyopathy even in the absence of previous heart disease. The robbers were convicted of homicide and sentenced to eighteen years in prison. Highlights: Tako-Tsubo is an acquired cardiomyopathy with no evidence of coronary heart disease. Tako-Tsubo is a catecholamine-induced cardiomyopathy, and it is often related to severe physical or emotional stress. The forensic interest is aroused by sudden cardiac death that could occur subsequently to a criminal act. Sudden cardiac death following a crime can be ruled to homicide according to autopsy findings and cardiac histology.