title: Forensic Analysis Reveals Acute Decompensation of Chronic Heart Failure in a 3500-Year-Old Egyptian Dignitary.
abstract: Naturally preserved and embalmed bodies from archeological contexts represent a powerful source of information for forensic investigators. They allow one to ascertain pathology, cause of death, to enhance diagnostic methodology, and to improve the analysis of altered remains. We investigated the complete head and lung remnants of a 3,500-year-old Egyptian dignitary by radiological, microscopic, and genetic approaches. The individual, a middle-aged male, suffered from severe periodontitis, mild atherosclerosis, and experienced cardiogenic pulmonary insufficiency with recurrent mini-bleeds and pulmonary edema. Histology and ancient DNA analyses excluded the presence of Mycobacterium tuberculosis or of any other pathogenic species. Based on our collection of evidence, we propose that acute decompensation complicating chronic cardiac insufficiency was the likely cause of death. The underlying causes for this failure remain unknown although chronic hypertension appears to be the most likely candidate. Our finding represents the earliest reported case of chronic heart failure in ancient mummies.
authors.affiliation: Legal Medicine Section, Department of Public Health and Paediatric Sciences, University of Turin, Corso Galileo Galilei, 22, 10126, Turin, Italy. raffaella.bianucci@unito.it, raffaella.bianucci@gmail.com.|UMR 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Bd Pierre Dramard, BAT A CS, 80011, 13444, Marseilles- Cedex 15- France. raffaella.bianucci@unito.it, raffaella.bianucci@gmail.com.
authors.forename: Raffaella
authors.identifier: 0000-0003-2740-4112
authors.initials: R
authors.lastname: Bianucci
authors.affiliation: KNH Centre for Biomedical Egyptology, University of Manchester, 3.5 Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Loynes
authors.affiliation: Newport Diagnostic Center, 1605 Avocado Avenue, Newport Beach, CA 92660.
authors.forename: M Linda
authors.initials: ML
authors.lastname: Sutherland
authors.affiliation: Clinica Pinna Pintor, Via Amerigo Vespucci 61, 10129, Turin, Italy.
authors.forename: Rudy
authors.initials: R
authors.lastname: Lallo
authors.affiliation: Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Medical School Building, Coventry, West Midlands CV4, United Kingdom.
authors.forename: Gemma L
authors.initials: GL
authors.lastname: Kay
authors.affiliation: Section of Medical and Forensic Anthropology (UVSQ & Paris 5 University EA 4569), 2 Avenue de la source de la Bièvre, Montigny-le-Bretonneux, 78180, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Froesch
authors.affiliation: Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Medical School Building, Coventry, West Midlands CV4, United Kingdom.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pallen
authors.affiliation: Section of Medical and Forensic Anthropology (UVSQ & Paris 5 University EA 4569), 2 Avenue de la source de la Bièvre, Montigny-le-Bretonneux, 78180, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Charlier
authors.affiliation: Institute of Pathology, Klinikum München-Bogenhausen, Englschalkinger Str. 77, 81925, Munich, Germany.
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Nerlich
mesh_terms: D050197:Atherosclerosis; D004534:Egypt; D018732:Forensic Anthropology; D006333:Heart Failure; D006801:Humans; D008168:Lung; D008297:Male; D009106:Mummies
keywords: forensic science; histology; mummified remains; pulmonary bleeding; pulmonary edema; shotgun metagenomics