title: Applying the Principles of Homicide by Heart Attack.
abstract: Homicide by heart attack is a well-established model in forensic pathology that describes death elicited during or immediately after a criminal act where a threat or fear of physical injury is present. After its introduction nearly 4 decades ago, the principle has undergone a handful of modifications but still maintains its core concepts. All cases of this nature during a 20-year period at the Wayne County Medical Examiner's Office were compared and contrasted for demographics, circumstances and scene investigation, and autopsy and toxicology findings. Of the cases fulfilling the previously established criteria for homicide by heart attack, more than 80% displayed significant changes because of hypertension. This finding coincides with the high prevalence of hypertension in our urban population and highlights the significance of this disease. Also present were minor external and internal injuries in select cases, which reinforce the understanding that physical contact between the decedent and assailant does not preclude this diagnosis.
authors.affiliation: From the Department of Pathology, University of Michigan, Ann Arbor; and the Wayne County Medical Examiner's Office, Detroit, MI.
authors.forename: Leigh
authors.initials: L
authors.lastname: Hlavaty
authors.forename: LokMan
authors.initials: L
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000473:pathology; D019548:Crime Victims / Q000523:psychology; D005239:Fear; D005260:Female; D049429:Forensic Pathology; D006331:Heart Diseases / Q000453:epidemiology; D006708:Homicide; D006801:Humans; D006973:Hypertension / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000473:pathology; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000473:pathology