Cardiac tamponade is a condition produced by the rapid accumulation of pericardial fluid, which restricts the filling of the heart. Often the forensic pathologist comes across different naturally occurring sudden deaths. Cardiovascular causes are the most common. Death due to cardiac tamponade can cause sudden cardiac death. Acute cardiac tamponade is almost invariably fatal, unless the pressure is relieved by removing the pericardial fluid, either by needle pericardiocentesis or surgical procedures. Cardiac tamponade is more commonly associated with cases of trauma, operative procedures, secondary to myocardial infarction or intra pericardial rupture of great vessels. Previous literature showed an association of cardiac tamponade with many other pathological conditions such as malignancy, central venous catheterisation, open heart surgery, dissecting aneurysm of the aorta, myocardial abscess, infective endocarditis, etc. We report a series of three cases where cardiac tamponade was given as the cause of death on autopsy secondary to post-myocardial infarction wall rupture.

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

Lightning is the discharge of an electric charge forming in the atmosphere between the earth and clouds which travels downward in a branching pattern. It is estimated that there are some 1800 active thunderstorms at any given moment. Lightning may injure or kill a person by a direct strike, a side-flash or conduction through another object. Agricultural workers are at risk in developing and underdeveloped countries, as are those engaging in sporting activities elsewhere. Fatalities resulting from lightning strikes may not show specific symptoms at autopsy, but there may be symptoms of burns on clothes and body and fernlike marks specific to lightning strikes on their bodies. Other signs are acute kidney failure, cardiac arrhythmias and deaths, and while internal organs may show oedema, congestion, etc, this is not in itself sufficient to establish causation. When diagnosing death from a lightning strike, it is essential to examine the deceased’s clothes, their external body and carry out a crime scene investigation. We report a series of three cases of death from a lightning strike in previously healthy men engaged in their daily activities.