Case report: Electrocardiographic (ECG) recording during the hanging process.
E M Ungermann1, M Balikowski2, J Hemker3
1Institute of Forensic and Legal Medicine, University Hospital Heidelberg, Vossstrasse 2, 69115, Heidelberg, Germany. e.ungermann@yahoo.de.
Forensic Science, Medicine, and Pathology
|August 11, 2024
Summary
This case study details the fatal cardiac electrical activity during atypical hanging. The electrocardiogram (ECG) revealed progressive heart block, culminating in asystole and death.
Area of Science:
- Forensic Pathology
- Cardiology
- Autopsy
Background:
- Hanging is a common cause of death.
- The cardiac pathophysiology during atypical hanging is not fully understood.
- Electrocardiogram (ECG) monitoring during such events is rare.
Purpose of the Study:
- To report and analyze ECG changes in a case of atypical hanging.
- To provide insights into the cardiac mechanisms of death in hanging.
Main Methods:
- A 48-year-old female victim of hanging was found with a Holter monitor.
- The Holter monitor recording was analyzed by a cardiologist.
- Autopsy findings were correlated with ECG data.
Main Results:
- The ECG demonstrated a 20-second asystole, followed by bradycardia.
- Progressive atrioventricular (AV) block occurred: Mobitz I, Mobitz II, and finally third-degree AV block.
- The tracing concluded with P waves only, preceding cardiac arrest.
Conclusions:
- This case highlights significant ECG abnormalities during atypical hanging.
- The findings contribute to understanding the complex pathophysiology of death by hanging.
- ECG monitoring can offer valuable data in forensic investigations of hanging deaths.
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