Death associated with wet cupping therapy (hijama): A case report

The World Health Organization defines traditional medicine as the sum of knowledge and practices unique to different cultures. Wet cupping therapy (hijama), a traditional medicine practice, holds religious and cultural significance, particularly in Middle Eastern and Islamic societies. However, this practice can lead to serious complications when performed under inappropriate conditions or by unqualified individuals. This study presents a case in which sudden cardiac death occurred following a hijama performed by an unlicensed practitioner on a patient diagnosed with ischemic stroke and a bladder tumor. In the case review, it was determined that hijama applied to different parts of the body on consecutive days may have contributed to hemodynamic instability and potentially precipitated sudden cardiac arrest due to cumulative blood loss and stress. Autopsy findings revealed myocardial fibrosis associated with previous myocardial infarction, and no other acute toxicological or pathological findings were present. While a direct causal link cannot be definitively proven, the close temporal association, forensic assessment, and lack of alternative causes suggest a plausible connection between the hijama procedure and the fatal outcome. This case underscores the importance of performing invasive traditional medicine practices under appropriate conditions and by authorized healthcare professionals. Raising awareness among the public and healthcare workers about such practices and ensuring the effective enforcement of legal regulations is critical to preventing potential complications.