Drowning of a girl with anomaly of the bundle of His and the right bundle branch.
We report an unusual case of a 17-year-old girl who died in an filled bathtub. There were at least two attacks of unconsciousness in her premortem history. In April 1994, electrocardiography had shown an incomplete right bundle branch block. At autopsy, unspecific signs of drowning and hypoplasia of the terminal part of the atrioventricular bundle of His and the right bundle branch within the cardiac conduction system were found. There were no other obvious autopsy findings related to the sudden death of this girl. In addition, toxicologic examination for illegal drugs and alcohol was completely negative. We conclude that this might be a rare case of death because of acute decompensation of a partial hypoplastic cardiac conduction system with loss of consciousness and consequent drowning in the bathtub. This case illustrates the value of an extensive pathologic examination of the cardiac conduction system in unexpected death of young people.
Stumpp
J W
JW
Institute of Legal Medicine, University of Zürich, Switzerland.
Schneider
J
J
Bär
W
W
D000293:Adolescent; D002036:Bundle of His / Q000002:abnormalities* / Q000473:pathology; D002037:Bundle-Branch Block / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004332:Drowning; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans