Sudden death of a young woman shortly after fleeing from violence.
A woman in her late-teens ran downstairs and out into the street to escape from violence by her boyfriend. She ran approximately 150 m and was suddenly collapsed immediately after stopping to call for help. She underwent cardiopulmonary resuscitation, which was unsuccessful. Autopsy revealed some minor injuries on the face, trunk and extremities. Meanwhile, the left coronary artery was originated from the right sinus of Valsalva, and the orifice had a slit-like appearance. Additionally, the main trunk of the left coronary artery coursed between the aortic sinus and the pulmonary trunk. Microscopically, the heart (240 g) showed small foci of contraction band necrosis and wavy changes. This type of coronary artery anomaly makes up only 0.0375% among all varieties of the anomaly according to a report of the US. However, it has a greater risk of sudden cardiac death during physical exercise. Taking the eyewitness testimony into account, we determined that the 150 m run at full speed, rather than the assault itself, had caused acute coronary insufficiency, leading the death of the decedent.
Takahashi
Shirushi
S
Division of Forensic Medicine, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. shirushi@forensic.med.tohoku.ac.jp
Funayama
Masato
M
D000293:Adolescent; D003330:Coronary Vessel Anomalies / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017579:Domestic Violence; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D009206:Myocardium / Q000473:pathology; D012420:Running