Takotsubo Cardiomyopathy in a Jeweler Following a Hold‐up: Forensic Considerations

Abstract

The authors present a case of takotsubo cardiomyopathy (TTC) following physical assault. In France, public prosecutor orders a medicolegal assessment after an assault for all living victims. Medicolegal assessment aims to establish a causal relation between an aggression and the injury sustained. An 80-year-old jeweler was the victim of assault, restraint and confinement during the hold-up of his jewelry store. After the event, he experienced constrictive chest pain with a sensation of oppression. Transthoracic echography showed apical and middle wall akinesis with apical ballooning pattern. In this case, the experts reasonably accepted that there was a direct, certain, and exclusive causal relation between the aggression and the cardiomyopathy. Forensic specialists should be aware of TTC because it is a frequent complication of stress situations and its incidence in forensic cases is probably underestimated.

Commentary on: Savall F, Dedouit F, Telmon N, Rouge D. Takotsubo cardiomyopathy in a jeweller following a hold‐up: forensic considerations. J Forensic Sci 2013;58:1648–50.

“…Sir, Savall et al (1) recently described an interesting case of Takotsubo cardiomyopathy. The jeweler described in the case developed Takotsubo cardiomyopathy after an assault, restraint, and confinement during the hold-up of his jewelry store.…”

“…Despite recognition by cardiologists, Takotsubo cardiomyopathy remains relatively unknown to other medical specialities. Increased awareness of this condition is of paramount importance among forensic specialists as this may have direct implication in medicolegal assessment as described by Savall et al (1).…”