No abstract

"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor. The latter punched her in the arms and kneed her in the gut without causing any intrathoracic or abdominal injury. The victim was urgently hospitalized in the cardiology department for chest pain and dyspnea accompanied by ST-segment elevation and high troponin level.Tako-tsubo cardiomyopathy diagnosis was based on clinical findings, echocardiography, coronary angiography, and magnetic resonance imaging findings. A forensic medicine consult was initially solicited for the drafting of an initial medical certificate and for evaluating the total transitory disability rate. A second consultation was then sought to evaluate the permanent partial disability.We report this work to discuss the conduct of the forensic pathologist and to prove the causality relationship between the assault and the physical injuries.

There are a great number of complex suicides in the literature. It is so interesting to expand the list and to publish more cases of complex suicide which are examined by forensic worldwide. It's interesting to know the maximum of method that can be used by suicidal individuals. We present a case of a complex suicide of a young woman by using ingestion of paraphénylène Diamine associated with self-strangulation by a link. Self-strangulation is probably used to accelerate death or to reduce pain caused by the first method. Forensic autopsy and further tests confirmed the voluntary intoxication by PPD and showed signs of strangulation by a loose link. The circumstances of the facts and the judicial inquiry were in favor of self-strangulation without the intervention of another person. This case illustrates an example of complex suicide. To our knowledge, it is the first case of complex suicide involving intoxication PPD and self-strangulation.