A CASE OF SUDDEN DEATH DUE TO EISENMENGER SYNDROME: A MEDICO-LEGAL CASE OF ACCIDENTAL FALL
Keywords:
Accidental fall, ventricular septal defect, right ventricular hypertrophy, Dilated pulmonary artery, Eisenmenger syndromeAbstract
Accidental fall cases which lead to sudden death are common among medicolegal post-mortem in all institutes, unexpectedly in some cases during autopsy rare underlying cardiac or brain pathologies are revealed. History of incident and injuries in those cases are not enough to conclude cause of death, pre-existing disease could precipitate death during incident. In this case, deceased was slipped while washing his hands and sustained minor external injuries. Autopsy revealed large membranous Ventricular Septal Defect (VSD), dilated right ventricle and pulmonary artery, pulmonary edema and cerebral edema. Although patient was a diagnosed case of left to right shunt and Eisenmenger Syndrome (ES), he was perfectly stable under specialist treatment. This rare case revealed gross findings of Eisenmenger syndrome due to ventricular septal defect, in the ground of sudden physical trauma sustained due to accidental fall as a potential bothersome factor to underlying natural disease process leading to death.
References
Ghormade, PS , Soni, JP, Sarma B, Dash SK. Autopsy findings in death due to Eisenmenger syndrome: A medico-legal case of road traffic accident. Forensic Science International: Reports 2020 (2): 100040. doi:0.1016/j.fsir.2019. 100040
Diller GP, Dimopoulos K, Broberg CS, Kaya MG, Naghotra US, Uebing A, et al. Presentation, survival prospects, and predictors of death in Eisenmenger syndrome: a combined retrospective and case-control study. Eur Heart J. 2006;27:1737-42.
Hari R, Poornima J, Seshabala M, Vidyadhara S. Eisenmenger syndrome in a patient with ventricular septal defect: a case report. Int J Res Med Sci. 2015 Jan;3(1):376-78
Wood P. The Eisenmenger syndrome or pulmonary hypertension with reversed central shunt. Br Med J. 1958;2(5099):755-62.
Vongpatanasin W, Brickner ME, Hillis LD, Lange RA. The Eisenmenger syndrome in adults. Ann Intern Med. 1998;128(9):745-55.
Diller GP, Gatzoulis MA. Pulmonary vascular disease in adults with congenital heart disease. Circulation. 2007;115(8):1039-50.
Campos FPF de, Benvenuti LA. Eisenmenger
syndrome. Autops. Case Rep. [Internet]. 2017Mar.29 [cited 2022Sep.3];7(1):5-7. Available from: https:// www.revistas.usp.br/autopsy/article/view/133297
Mebus S, Schulze-Neick I, Oechslin E, Niwa K, Trindade PT, Hager A, Hess J, Kaemmerer H. The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part II: Medical Treatment - Study Results. Curr Cardiol Rev. 2010 Nov;6(4):356- 62.
Kidd L, Driscoll DJ, Gersony WM, Hayes CJ, Keane JF, O’Fallon WM, et al. Second natural history study of congenital heart defects: results of treatment of patients with ventricular septal defects. Circulation. 1993;87:138-51.
Young D, Mark H. Fate of the patient with the Eisenmenger syndrome. Am J Cardiol. 1971 Dec;28(6):658-69.
Duffels MG, Engelfriet PM, Berger RM, van Loon RL, Hoendermis E, Vriend JW, van der Velde ET, Bresser P, Mulder BJ. Pulmonary arterial hypertension in congenital heart disease: an epidemiologic perspective from a Dutch registry. Int J Cardiol. 2007 Aug 21;120(2):198-204.
Clarkson PM, Frye RL, DuShane JW, Burchell HB, Wood EH, Weidman WH. Prognosis for patients with ventricular septal defect and severe pulmonary vascular obstructive disease. Circulation. 1968 Jul;38(1):129-35.
Botto LD, Correa A, Erickson JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics. 2001 Mar;107(3) e32.
Bjornard K, Riehle-Colarusso T, Gilboa SM, Correa A. Patterns in the prevalence of congenital heart defects, metropolitan Atlanta, 1978 to 2005. Birth Defects Res A Clin Mol Teratol. 2013 Feb;97(2):87-94.
Kaemmerer H, Mebus S, Schulze-Neick I, Eicken A, Trindade PT, Hager A, Oechslin E, Niwa K, Lang I, Hess J. The adult patient with eisenmenger syndrome:
