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"Rigor mortis" in a live patient
1Department of Anesthesiology, Critical Care and Pain Relief, Wockhardt Heart Institute, Bangalore, Karnataka 560076, USA. mailchakravarthy@gmail.com
Abstract:
Rigor mortis is conventionally a postmortem change. Its occurrence suggests that death has occurred at least a few hours ago. The authors report a case of "Rigor Mortis" in a live patient after cardiac surgery. The likely factors that may have predisposed such premortem muscle stiffening in the reported patient are, intense low cardiac output status, use of unusually high dose of inotropic and vasopressor agents and likely sepsis. Such an event may be of importance while determining the time of death in individuals such as described in the report. It may also suggest requirement of careful examination of patients with muscle stiffening prior to declaration of death. This report is being published to point out the likely controversies that might arise out of muscle stiffening, which should not always be termed rigor mortis and/ or postmortem.
Insights
Rigor mortis, typically a postmortem sign, was observed in a live patient after cardiac surgery. This premortem muscle stiffening may complicate death determination and requires careful clinical evaluation.
Area of Science:
- Medical Science
- Physiology
- Pathology
Background:
- Rigor mortis is a well-established postmortem indicator of death, signifying muscle stiffening occurring hours after cessation of life.
- Conventional understanding dictates that rigor mortis is exclusively a phenomenon observed after death.
Observation:
- A rare case of "Rigor Mortis" was documented in a live patient following cardiac surgery.
- This premortem muscle stiffening occurred despite the patient being alive.
Findings:
- Intense low cardiac output, high doses of inotropic and vasopressor agents, and potential sepsis were identified as likely predisposing factors.
- These physiological stressors may induce muscle stiffening before death.
Implications:
- The occurrence of premortem muscle stiffening challenges the definitive use of rigor mortis in determining time of death.
- Healthcare professionals must exercise caution and conduct thorough examinations to differentiate premortem stiffening from true rigor mortis, avoiding premature declaration of death.
