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Fatal right coronary artery rupture following blunt chest trauma: detection by postmortem selective coronary angiography
- Source :
- International journal of legal medicine. 130(3)
- Publication Year :
- 2015
-
Abstract
- Coronary artery injury is a rare complication following blunt chest trauma (BCT), and can be fatal. Here we report findings on postmortem selective coronary angiography of right coronary artery rupture after an assault involving blunt trauma to the chest. A woman in her 60s died after her son stomped on her chest. There were no appreciable signs of injury on external examination, and cause of death could not be determined by postmortem computed tomography (PMCT). Internal findings indicated that an external force had been applied to the anterior chest, as evidenced by subcutaneous hemorrhage and pericardial and cardiac contusions. Postmortem coronary angiography revealed irregularity of the intima and of the fat tissue surrounding the proximal part of the right coronary artery associated with a local filling defect. Histopathological examination suggested coronary rupture with dissection of the tunica media and compression of the lumen cavity. The key points in the present case are that no fatal injuries could be determined on external examination, and the heart and coronary artery injuries were not evident on PMCT. Criminality might be overlooked in such cases, as external investigation at the crime scene would be inadequate and could result in a facile diagnosis of cause of death. This is the first report of coronary artery rupture with dissection that was detected by CT coronary angiography, and provides helpful findings for reaching an appropriate decision both forensically and clinically.
- Subjects :
- Tunica media
medicine.medical_specialty
Lumen (anatomy)
030204 cardiovascular system & hematology
Coronary Angiography
Wounds, Nonpenetrating
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Blunt
Fatal Outcome
Anterior chest
Internal medicine
medicine.artery
medicine
Humans
030216 legal & forensic medicine
Cause of death
Rupture
business.industry
Middle Aged
Coronary Vessels
medicine.anatomical_structure
Blunt trauma
Right coronary artery
Cardiology
Female
Radiology
business
Tomography, X-Ray Computed
Tunica Media
Artery
Subjects
Details
- ISSN :
- 14371596
- Volume :
- 130
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- International journal of legal medicine
- Accession number :
- edsair.doi.dedup.....9afbb59c173ac58697e94f7cadaf09d4