THE CHALLENGE OF DIAGNOSIS: CARDIAC TAMPONADE IDENTIFIED AT AUTOPSY
DOI:
https://doi.org/10.48165/jfmt.2025.42.3.22Keywords:
Cardiac Tamponade, Myocardial infarction (MI), Sudden natural deathAbstract
There has been a rise in the incidence of sudden death among individuals in middle age. Predominantly, cardiovascular diseases have seen to be the most leading cause behind such deaths. Despite being a relatively uncommon presentation, cardiac tamponade presents as one of the rare yet fatal complications. This condition manifests when the pericardial cavity becomes filled with either blood or blood clots, compromising the heart’s normal contractile function. Typically, patients experiencing cardiac tamponade are often reported to have succumbed to sudden death, with history of chest pain. The definitive diagnosis of cardiac tamponade usually occurs during post-mortem examinations during Autopsy. We consider the case of a 45-year-old man who was found unconscious at his residence and was pronounced dead upon arrival at the hospital. Subsequent autopsy findings unveiled the presence of both blood and blood clots within the pericardial cavity, in conjunction with a rupture in the left ventricle and occlusion of the right coronary artery. Histopathological examination further confirmed the root cause of this fatal event as an acute myocardial infarction.
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Patil, A., Singh, N., Vigneshwaran, S., Bharti, S., & Sudhakar, S. (2022). Sudden death due to cardiac tamponade secondary to myocardial infarction ventricular wall rupture. Cureus, 14(10), e30288. https://doi.org/10.7759/cureus.30288
. PMID: 36407257; PMCID: PMC9654589.
Chhabra, H. S., Kumar, A., Kaur, N., & Chhabra, D. S. (2021). Cardiac tamponade and its medicolegal aspects: A case report. Medicine, Science and the Law, 89(2), 145–147. https://doi.org/10.1177/0025817220980680
. Epub 2021 Jan 21. PMID: 33475045.
Sonwani, N. S., Ateriya, N., & Kumar, A. (2019). Dying from haemorrhagic cardiac tamponade – a case series. Medicine, Science and the Law, 87(4), 210–214. https://doi.org/10.1177/0025817219867268
. Epub 2019 Oct 4. PMID: 31584847.
Chandru, K., et al. The challenge of diagnosis: Cardiac tamponade identified at autopsy.
Kondo, T., Nagasaki, Y., Takahashi, M., Nakagawa, K., Kuse, A., Morichika, M., Sakurada, M., Asano, M., & Ueno, Y. (2016). An autopsy case of cardiac tamponade caused by a ruptured ventricular aneurysm associated with acute myocarditis. Legal Medicine (Tokyo), 18, 44–48. https://doi.org/10.1016/j.legalmed.2015.12.002
. Epub 2015 Dec 8. PMID: 26832375.
Alerhand, S., Adrian, R. J., Long, B., & Avila, J. (2022). Pericardial tamponade: A comprehensive emergency medicine and echocardiography review. American Journal of Emergency Medicine, 58, 159–174. https://doi.org/10.1016/j.ajem.2022.05.001
. Epub 2022 May 6. PMID: 35696801.
Spodick, D. H. (2003). Acute cardiac tamponade. New England Journal of Medicine, 349(7), 684–690. https://doi.org/10.1056/NEJMra022643
. PMID: 12917306.
Angel, S., M. V., & Pradhan, P. (2024). Cardiac tamponade and myocardial infarction: A case report. Cureus, 16(6), e63284. https://doi.org/10.7759/cureus.63284
. PMID: 39070503; PMCID: PMC11283069.
Slater, J., Brown, R. J., Antonelli, T. A., Menon, V., Boland, J., Col, J., Dzavik, V., Greenberg, M., Menegus, M., Connery, C., & Hochman, J. S. (2000). Cardiogenic shock due to cardiac free-wall rupture or tamponade after acute myocardial infarction: A report from the SHOCK Trial Registry. Journal of the American College of Cardiology, 36(3 Suppl A), 1117–1122. https://doi.org/10.1016/s0735-1097(00)00845-7. PMID: 10985714.
Tsukube, T. (2023). Decision making and management of acute type-A dissection presenting with shock or cardiac arrest. Asian Cardiovascular & Thoracic Annals, 31(1), 20–25. https://doi.org/10.1177/02184923211060574
. Epub 2022 Feb 15. PMID: 35167350.
Huang, L., Li, T., He, Z. Z., & Liu, Y. W. (2016). Acute hemorrhagic cardiac tamponade as presenting findings of transmural myocardial infarction in an adult patient. Chinese Medical Journal (Engl), 129(5), 618–619. https://doi.org/10.4103/0366-6999.176990
. PMID: 26905002; PMCID: PMC4804449.
Narayan Reddy, K. S., & Murthy, O. P. (2022). The essentials of forensic medicine & toxicology (35th ed., p. 206). Jaypee Brothers Medical Publishers.
Sonwani, N. S., Ateriya, N., & Kumar, A. (2019). Dying from haemorrhagic cardiac tamponade – a case series. Medicine, Science and the Law, 87, 210–214. https://doi.org/10.1177/0025817219867268
Patil, A., Singh, N., Vigneshwaran, S., Bharti, S., & Sudhakar, S. (2022). Sudden death due to cardiac tamponade secondary to myocardial infarction ventricular wall rupture. Cureus, 14(10), e30288. https://doi.org/10.7759/cureus.30288. PMID: 36407257; PMCID: PMC9654589.
Satish, N. T., Shetty, A. R. S., & Harish, S. et al. (2014). Sudden death due to cardiac tamponade – a case report. International Journal of Health Sciences and Research, 4(6), 239–243.
Eranti, A., et al. (2024). Spontaneous cardiac tamponade as a cause of sudden unexpected death with focus on coronary aneurysms. Journal of the Society for Cardiovascular Angiography & Interventions, 3(1). https://doi.org/10.101249
