Paradoxical air embolism through patent foramen ovale during consensual intercourse in a non-pregnant young female.
Sudden vaginal bleeding and a cardiac arrest occurred in a 18-year-old female during consensual intercourse. Resuscitation procedures, applied at the arrival of a medical emergency team, restored the cardiac function allowing admission to hospital, where two vaginal mucosal lacerations were diagnosed and sutured. Cardiological investigations diagnosed a left ventricle myocardial infarction and a patent foramen ovale while a brain CT scan showed ischemic signs and intravascular air images. Death occurred after 48 h, due to heart failure, cerebral anoxia and multiorgan failure. Autopsy confirmed a patent foramen ovale considered as responsible for a paradoxical air embolism. Judicial Authority evaluated the fatal paradoxical air embolism as a consequence of an unpredictable accident occurred during consensual intercourse without sexual violence.
Department of Medical Morphological Research, Section of Forensic Medicine, University of Udine, Italy.
Carlo
C
Moreschi
Ugo
U
Da Broi
D000059:Accidents; D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging; D003075:Coitus; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D054092:Foramen Ovale, Patent / Q000473:pathology*; D049429:Forensic Pathology; D006323:Heart Arrest / Q000209:etiology; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D009102:Multiple Organ Failure / Q000209:etiology*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed