8 - sudden natural death part1

8/2/2019 8 - Sudden Natural Death Part1

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Sudden Natural Death


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Objectives Classifications and definitions of the types of

unexpected deaths.

Preliminary steps in the investigation.

Scene investigation.

The postmortem examination.


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Definitions and classifications

SD is defined as a natural, unexpected fatal event, inan apparently healthy subject or one whose diseasewas not so severe enough as to predict such an abruptoutcome.

WHO definition:

Death occur within 24 hrs of the onset ofsymptoms.

Forensic sense:Most of such deaths die in minutes or even

seconds of the onset of symptoms.

Its difficult to find the exact classification of suddenunexpected deaths , the problem comes from thedefinitions of both sudden and unexpected.

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The aim of classifying the death into

sudden and unexpected death is to

remove the ones that are epidemic and

traumatic.

The more unexpected the death, the less

reliable the information will be due to the

shock of death


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Preliminary steps in theinvestigationClinical and investigation information: Death can be certified by an attending physician that has seen

the patient recently, and is convinced that the death was

caused by lethal disease that he knew the patient was suffering

from. When the physician cant certify that the death was caused by

the disease, then medicolegal investigations must be done.

Sometimes even after autopsy, the cause of death may still be

unknown.


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Examples : ElectrocutionSucide


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Special procedures

Photographs.

Radiographs.

Collection and preservation of evidence and/or

specimen.

Toxicological examinations.


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Special problems

Special problems arise in certain cases andsituations, because they require more investigationthan usual, and because they have the mostpotential for serious error:

No Identification. No cause of death.

Environmental exposure.

Decomposed body.

Skeletal remains. Deaths in police custody and police shootings.

Mass disaster.


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Postmortem Examination

There should be careful examination of :

External surface :

For evidence of injury and resuscitation.

Internal examination :

Will be extremely important in a death considered

sudden and unexpected.


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Causes of SND

Cardiovascular system diseases.

A. Heart diseases

B. Vascular diseases

Respiratory system diseases.

Gastrointestinal system diseases.

Gynecological system diseases.

Central nervous system diseases.


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1. Cardiovascular System

Cardiovascular disease is the most common

cause of sudden unexpected deaths in adults.

It is the leading cause of deaths in MEN

between 20-65 years of age.

Most of cardiovascular diseases related

deaths are mainly due to coronary

atherosclerosis.


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A-Heart Diseases

Coronary artery disease.

Hypertensive heart disease.

Cardiomyopathies

Valvular heart diseases.

Myocarditis.

Infective endocarditis.


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Myocarditis

Many infective diseases produce an acutemyocarditis which may be an acute cause ofdeath.

More important is isolated myocarditis where

the condition is primary and usually ofunknown origin.

The criteria for the diagnosis is to findinflammatory and infiltrative degenerative or

necrotic myocytes. Viruses (eg. Influenza) infections are the most

common cause of myocarditis.


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Infective endocarditis

The commonest cause are various types of

bacteria, though viruses and other

microorganism may also be responsible. the

symptoms are often vague, so the conditionmay not be diagnosed during life.


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B- vascular disease

Ruptured atheromatous aortic aneurysm.

Dissecting aortic aneurysm.

Cerebrovascular disease.


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THANK YOU

8 - sudden natural death part1

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