Sudden cardiac death after robbery: Homicide or natural death?

Bottari, Giampiero; Trotta, Silvia; Marzullo, Andrea; Meliota, Giovanni; Ciccone, Marco Matteo; Solarino, Biagio

doi:10.1016/j.jflm.2020.102057

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…performed a myocardial biopsy on the day of admission of a 29‐year‐old woman with TTS and found neutrophilic infiltration in the myocardium 39 . Similar results were seen in several other autopsy cases 40,41 . In a histopathologic study, the myocardium of 25 patients who died of subarachnoid haemorrhage and 18 controls was stained with antibodies identifying neutrophil granulocytes (myeloperoxidase).…”

Section: Other Immune Cells In Ttssupporting

confidence: 60%

“… 39 Similar results were seen in several other autopsy cases. 40 , 41 In a histopathologic study, the myocardium of 25 patients who died of subarachnoid haemorrhage and 18 controls was stained with antibodies identifying neutrophil granulocytes (myeloperoxidase). The findings revealed that in the myocardium of subarachnoid haemorrhage patients, the number of myeloperoxidase‐positive cells was significantly higher than it was in controls.…”

Section: Other Immune Cells In Ttsmentioning

confidence: 99%

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The role of inflammation in takotsubo syndrome: A new therapeutic target?

Li,

Yang,

2024

J Cellular Molecular Medi

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Takotsubo syndrome (TTS) is a particular form of acute heart failure that can be challenging to distinguish from acute coronary syndrome at presentation. TTS was previously considered a benign self‐limiting condition, but it is now known to be associated with substantial short‐ and long‐term morbidity and mortality. Because of the poor understanding of its underlying pathophysiology, there are few evidence‐based interventions to treat TTS. The hypotheses formulated so far can be grouped into endogenous adrenergic surge, psychological stress or preexisting psychiatric illness, coronary vasospasm with microvascular dysfunction, metabolic and energetic alterations, and inflammatory mechanisms. Current evidence demonstrates that the infiltration of immune cells such as macrophages and neutrophils play a pivotal role in TTS. At baseline, resident macrophages were the dominant subset in cardiac macrophages, however, it underwent a shift from resident macrophages to monocyte‐derived infiltrating macrophages in TTS. Depletion of macrophages and monocytes in mice strongly protected them from isoprenaline‐induced cardiac dysfunction. It is probable that immune cells, especially macrophages, may be new targets for the treatment of TTS.

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Section: Other Immune Cells In Ttssupporting

confidence: 60%

Section: Other Immune Cells In Ttsmentioning

confidence: 99%

The role of inflammation in takotsubo syndrome: A new therapeutic target?

Li,

Yang,

2024

J Cellular Molecular Medi

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“…Given the intricate nature of scenarios related to viruses and the questionable histological cut-offs for infant death in myocarditis, this case demonstrates the need for an integrated and multidisciplinary approach, in order to understand the etiopathogenesis of sudden cardiac death, which can be extremely challenging, especially in the forensic scenario [ 23 - 25 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenges and forensic implications in a case of infantile fatal myocarditis

Grimaldi

Bonasoni

Pelletti

et al. 2023

Forensic Sci Med Pathol

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We present the case of a 23-month-old child who died less than 24 h after the onset of cardiac symptoms, despite being admitted to the hospital 72 h earlier. Autopsy revealed no significant macroscopic changes, and histologic examination revealed focal lymphocytic myocarditis with myocyte disruption, diffuse alveolar damage in the exudative phase, and generalized lymphocytic immune activation in other organs. Ante-mortem and post-mortem microbiological exams did not clearly prove a causative role of infectious agents. The peculiarity of this case was characterized by the contrast between the severe clinical features and the mild cardiac histological findings. This discrepancy, coupled with the suspicion of a viral causative role based on both ante-mortem and post-mortem microbiological examinations, presented significant challenges in reaching an etiological diagnosis. This case also confirms that the diagnosis of myocarditis in children cannot be made solely on the basis of histological cut-offs or microbiological results. Using abductive reasoning, various diagnostic hypotheses were formulated and evaluated to arrive at the final diagnosis of fatal myocarditis of viral or post-viral origin. Data from post-mortem examination are often the only source of information that is available to the experts, especially in cases of sudden infant death syndrome. In such cases, the forensic pathologists should accurately evaluate findings that may appear to indicate a different etiology, and, in the absence of clinical or radiological data, interpret post-mortem data in a logically correct manner. The autopsy is the first essential step to evaluate the cause of death and must be integrated with the results of ante- and post-mortem diagnostic tests in a holistic approach, which is crucial to allow forensic pathologists to provide an appropriate and relevant opinion.

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Approach to natural deaths (adult)

Ely¹,

Gill²

2023

Principles of Forensic Pathology

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Sudden cardiac death after robbery: Homicide or natural death?

Cited by 7 publications

References 20 publications

The role of inflammation in takotsubo syndrome: A new therapeutic target?

The role of inflammation in takotsubo syndrome: A new therapeutic target?

Diagnostic challenges and forensic implications in a case of infantile fatal myocarditis

Approach to natural deaths (adult)

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