Dying from haemorrhagic cardiac tamponade – a case series

Abstract

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.

Sudden Death Due to Cardiac Tamponade Secondary to Myocardial Infarction Ventricular Wall Rupture

“…CT has varied etiology which includes traumatic and non-traumatic causes. A case series reported three cases that suffered CT secondary to post-myocardial infarction wall rupture similar to this case and recognized CT as an uncommon complication of myocardial infarction [ 5 ].…”

“…CT is more frequently associated with cases of trauma, intra-pericardial rupture of great vessels, operative procedures, and secondary to myocardial rupture. It is also associated with other conditions such as central venous catheterization, open heart surgery, malignancy, and dissecting aneurysms involving the aorta [ 5 ]. Ventricular rupture is a rare but fatal mechanical complication of acute myocardial infarction (AMI) and is responsible for as many as 15% of total early deaths in patients with AMI [ 6 ].…”

Cardiac tamponade and its medicolegal aspects: A case report

“…1 Cardiac tamponade has been attributed to pericarditis (infectious and non-infectious), iatrogenic (cardiac invasive procedures and post-surgery), malignancy, collagen diseases (systemic lupus erythematosus, rheumatoid arthritis, scleroderma), radiation, aortic dissection, uraemia, post-myocardial infarction, bacterial infection, ruptured coronary artery aneurysm and trauma (penetrating and blunt). [2][3][4][5][6][7] In delayed pericardial effusion/haemopericardium, the literature suggests that some patients presenting with penetrating cardiac injuries may be completely stable, and the diagnosis can be missed. Also, these patients may not present with the classical findings of raised venous pressure, hypotension and muffled heart sounds and the chest X-ray may not reveal an enlarged heart shadow.…”