Sudden Death Due to Cardiac Tamponade Secondary to Myocardial Infarction Ventricular Wall Rupture

Area of Science:

• Forensic Pathology
• Cardiovascular Pathology

Background:

• Sudden cardiac death (SCD) is frequently attributed to cardiovascular diseases in forensic practice.
• Cardiac tamponade (CT) is a critical complication leading to SCD, often diagnosed during autopsy.
• CT can result from trauma or non-traumatic causes, including acute myocardial infarction (AMI).

Observation:

• A 50-year-old male experienced sudden collapse and death.
• Autopsy revealed significant pericardial effusion (250 mL blood) and a large clot (206 g).
• A vertical tear was noted on the left ventricle's posterolateral surface, indicative of myocardial rupture.

Findings:

• The cause of death was determined to be cardiac tamponade secondary to myocardial rupture.
• Histopathology confirmed transmural myocardial infarction and left ventricular rupture.
• Thrombosis of the left circumflex artery was identified as the underlying cause of the infarction.

Implications:

• This case highlights AMI as a cause of non-traumatic cardiac tamponade and sudden death.
• Accurate diagnosis relies on comprehensive gross and histopathological examination.
• Understanding these mechanisms is crucial for forensic investigations of sudden cardiac death.