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Sudden deaths of cardiac origin are usually caused by unexpected loss of heart function. One of the causes may be Infective endocarditis (IE) which refers to the microbial infection of the heart valves or mural endocardium that leads to the formation of thrombotic vegetations that cause calcification and destruction of underlying cardiac tissue. The vegetations are typically friable and embolize easily causing abscesses (Ring abscess), septic infarcts and mycotic aneurysms. Left untreated, IE may lead to congestive heart failure (CHF). Hence, it is important to discuss cases where IE was the main cause for death. Case suggested of a 67-year-old female who developed breathlessness, was taken to a local hospital and later brought to a multi-speciality hospital on the advice of doctors where she was declared brought dead. Internal Examination revealed the brain to be soft, congested and oedematous. There was coning of the orbital part of the frontal lobe, uncal part of the hippocampal gyrus of the temporal lobe and the cerebellar tonsil bilaterally. Tracheal lumen contained blood stained mucoid fluid. White patch was present on the anterior surface of the right ventricle 4 cm above apex. Right coronary artery showed 50% occlusion in its entire course. Left anterior descending artery showed 75% occlusion for 4cm from its origin. Multiple atheromatous streaks and plaques were present over the aortic intima at several places. Histopathology suggested chronic myocardial infarct with left coronary artery atherosclerosis. Pseudo hyphae were noticed in the vegetation's on the heart valve which were confirmed to be belonging to the genus Candida. Final opinion as to the cause of death after hospital records, autopsy findings, histopathology report and RFSL reports-due to sequelae of fungal infective endocarditis. [ABSTRACT FROM AUTHOR]

Amniotic fluid embolism (AFE) is one of the most catastrophic complications of pregnancy in which it is postulated that amniotic fluid, fetal cells, hair, or other debris enters the maternal pulmonary circulation, causing cardiovascular collapse and other complications which are a cause of high case fatality. It was first reported by Meyer in 1926. The incidence of Amniotic fluid embolism is rare, and the exact pathophysiology is still unknown. The process is similar to anaphylaxis than to embolism, so also termed as anaphylactoid syndrome of pregnancy because foetal tissue or amniotic fluid components are not universally found in women who present with signs and symptoms attributable to AFE. This is a case of a 27-year old female who developed severe bleeding after delivery of a male child and died 3 hours later to it. The post mortem report showed 50 ml of straw-coloured fluid in both the right and left pleura. Section from lung shows dilated and preserved alveolar air spaces with luminal secretions; surrounded by congested and inflamed interstitium, with congested blood vessels as per the histopathological report. Vessels showed luminal lamellated keratin flakes and squamous cells. The cause of death on examination was found to be amniotic fluid embolism. Since there was no indication of any sort of abdominal trauma therefore in such cases it becomes important to figure out the possible reasons behind the development of amniotic fluid embolism in an apparently normal individual. Though it is a rare condition, an early diagnosis of amniotic fluid embolism is necessary to prevent fatality. [ABSTRACT FROM AUTHOR]