Undiagnosed rheumatic carditis causing sudden death in a young adult: A case report and review.

Acute rheumatic fever-related acquired heart disease in children and young adults is a worldwide issue, but it poses a serious public health threat in developing nations like India. We present a case report of a young adult who collapsed suddenly during a routine walk and was declared dead in an emergency ward on arrival. There was no significant past medical history. On autopsy, massive cardiomegaly and a "butter and bread" appearance of the pericardium, along with findings suggestive of mitral stenosis and aortic regurgitation, raised suspicion about rheumatic heart disease. Rheumatic carditis was confirmed by a microscopic examination that showed Aschoff bodies in the left ventricle, mitral valve and interventricular septum, in addition to uncommon Anitschkow cells in the left ventricle. A sudden death due to undiagnosed rheumatic carditis causing such massive cardiomegaly is rare. This case highlights the need to keep rheumatic carditis as a cause of sudden death.

Sudden death due to spontaneous rupture of the right atrium in the setting of chronic lung disease: A case report and review.

Sudden death from haemopericardium as a result of a right atrial rupture is uncommon, most particularly when this occurs spontaneously without any prior trauma or evidence of atrial wall pathology. The deceased was a 32-year-old man. At lunchtime his symptoms of unease, giddiness and unconsciousness began and within 45 minutes he arrived at the hospital. His vitals could not be recorded in the emergency department, and after CPR, he was pronounced dead. At autopsy, an isolated right atrial rupture, without any disease of the heart wall, was discovered. The right atrium has the weakest wall and is frequently the site of spontaneous rupture brought on by increased intraluminal pressure. Both liquid blood and clotted blood were found in the pericardial cavity. Low atrial pressure encourages clot formation because it causes considerably slower blood entry into the pericardium at the time of atrial rupture compared with entry at the time of ventricular rupture. Evidence of chronic lung disease was found which explains the raised intraluminal pressure of the heart chambers. Even with no history of trauma or myocardial infarction, the Beck triad - an engorged neck vein, a muffled heart sound, and low blood pressure - should alert the emergency room staff to the possibility of cardiac tamponade because, in a very unlikely scenario, spontaneous cardial wall rupture might occur.

Death of a child due to venom toxicity following multiple honey bee stings: A case report.

Most bee stings are not life-threatening. Bee venom often causes local, mild allergic reactions in people, but even a single bee sting may induce a fatal anaphylactic reaction. Usually, anaphylactic reaction is the cause of death, but, when a child suffers multiple stings (more than 30), direct toxicity of venom can also be fatal. A three-year-old male child was brought to the hospital with pain, swelling and redness at the sting sites. He had more than 35 stings at various sites over his face, on his tongue and over his body. He died 10 hours after the incidence of the honey bee stings and was maintaining oxygen saturation until the terminal stage of his life. At autopsy, the honey bee sting sites showed redness, swelling and a small effusion of blood surrounding the stinger tracks. On the tongue two stingers were found in situ. Facial puffiness and eyelid swelling, along with congested organs, were also found, but features suggestive of anaphylactic death like airway oedema, mucous plug or cyanosis were absent. Hospital treatment records show that blood pressure remained low with tachycardia despite treatment. Having regard for all the evidence it was concluded that death was due to multiple honey bee stings that caused direct venom toxicity.

Asphyxiophilic death due to masochistic behaviour in a video game addict teen: A case report and reviews.

The disorder of internet gaming is increasingly being blamed on major psychological problems affecting youth. Action video games are enjoyable for masochists. Video game chores that practise bondage and other acts that cause pain and anoxia may be masochistic in nature in order to promote player satisfaction. Asphyxia will result in pleasure in asphyxiophilia, a dangerous and occasionally lethal form of sexual masochism. Constriction of the neck with ligature materials is a frequent method of causing hypoxia. The subject of this case study was a compulsive player of online video games. During the masochistic act, along with a recording of it, he unintentionally died. Given that he was naked, had a ligature around his neck, had his wrists and legs bound, and had two fabric-holding clamps on his scrotum, asphyxiophilia was determined to be the cause of his death. At the scene of death, neither pornographic materials nor proof of frequent use of this kind of behaviour were discovered. Along with recording, the subject's cell phone's flash was on to help with the dim lighting and he may have been videotaping these masochistic acts as part of a videogame task. The results of the autopsy, circumstantial evidence, police inquiry and witness accounts all support accidental death.

Forensic perspective of detecting ethanol with a breath analyser.

Breathalysers are commonly employed to diagnose drunk drivers but their ability to accurately measure levels of ethanol will depend on a number of variables, including the instrument's quality, environmental temperature, pattern of respiration, the consumption of food and drugs, pathological condition, metabolic state, and mouth alcohol. This article will consider how these factors affect results and provides suggestions on how to improve the test's admissibility in evidence.