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Cardiac Enlargement in a Medicolegal Autopsy Setting

Torfinn Beer1, Anders Eriksson1, Carl Johan Wingren2

  • 1From the Department of Community Medicine and Rehabilitation/Forensic Medicine, Umeå University, Umeå.

The American Journal of Forensic Medicine and Pathology
|October 11, 2023
PubMed

Insights

New heart weight references for medicolegal autopsies are now available. This study provides a model to accurately diagnose cardiac enlargement in autopsy populations, improving diagnostic accuracy.

Area of Science:

  • Forensic Pathology
  • Cardiovascular Pathology

Background:

  • Accurate heart weight references are crucial for diagnosing cardiac enlargement in medicolegal autopsies.
  • Existing references are often not representative of autopsy populations, leading to underestimation of heart weights.

Purpose of the Study:

  • To develop a more applicable heart weight model for medicolegal autopsy populations.
  • To account for undiagnosed cardiac enlargement in reference ranges.

Main Methods:

  • Utilized data from 11,897 Swedish medicolegal autopsy cases (2010-2019).
  • Developed a heart weight model incorporating factors relevant to autopsy populations.
  • Validated the model using data from 296 nonobese young adult suicidal hanging cases.

Main Results:

  • For an average height decedent (174 cm), weak, substantial, and strong evidence for enlarged heart weight was observed at approximately 430 g, 480 g, and 520 g, respectively.
  • Modeled prevalence of cardiac enlargement was notably high in elderly and obese decedents.
  • The model quantifies diagnostic uncertainty, aiding pathologists.

Conclusions:

  • The developed heart weight model is more applicable to medicolegal settings than previous references.
  • This tool enhances the diagnostic capability of pathologists in identifying cardiac enlargement.
  • An online tool is available to facilitate the model's practical application.

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