MYOCARDIAL INFARCTION DUE TO PRONOUNCED ANEMIA AS A RARE CAUSE OF DEATH

A. Wegner, B. Madea, E. Doberentz

Abstract: A 44-year-old man died suddenly and unexpectedly. Police investigations were carried out because the man had been robbed about a week before his death and he had been beaten on his head. A laceration on the back of the head as well as a bilateral orbital hematoma was detected during the police coroner’s examination. During the forensic autopsy, a nonvital, dried-out abrasion of the scalp was found instead of a “laceration.” Typical findings of pronounced anemia were found. Chronic blood loss could be considered due to the presence of esophageal varices and low blood content in the gastrointestinal tract. In the area of the left posterior wall of the ventricle (cardiac weight 312 g), a patchy, map-like area with a red rim was found in the absence of coronary sclerosis. Histological examinations showed a necrosis area in the heart muscle tissue. Therefore, the cause of death was an acute heart attack with pronounced anemia, possibly in combination with chronic blood loss from the gastrointestinal tract. Myocardial infarction can result from pronounced anemia and the resulting relative coronary insufficiency, even without previous damage to the heart.
Keywords: Myocardial infarction type 2, anemia, relative coronary insufficiency, rare cause of death, chronic blood loss, forensic pathology