POST-MORTEM DIAGNOSIS AND MEDICO-LEGAL ISSUES OF CARDIAC SUBSEQUENT DEATH IN A CONTEXT OF STRESS
(About an autopsy case)
Introduction: The interaction between stress, whether physical or emotional, and cardiac events is proving critical, especially when no pre-existing heart disease is apparent. This dynamic raises both medical and legal questions, such as how stressful events can lead to fatal outcomes, and how such cases are handled legally. This complexity highlights the need for interdisciplinary approaches to assessing cause and responsibility in such scenarios, incorporating established medico-legal criteria.
Case report: The reported case concerns a 64-year-old man, with no notable medical history, who was physically assaulted by his son-in-law. Suffering from chest pain, he consulted the emergency department, where he was diagnosed with chest pain with no abnormalities on chest X-ray. A subsequent altercation led to his sudden death. Autopsy revealed a ruptured left ventricle with significant hemopericardium, with no apparent external traumatic lesions.
Discussion: The medical section of the article examines the impact of emotional and physical stress on pre-existing cardiac conditions, highlighting the importance of thorough evaluation in determining cause of death. It also discusses the diagnostic challenges encountered at autopsy and the implications of these findings for forensic evaluations. Legally, the article compares Moroccan legislation concerning death without intent to kill with international standards, explaining the nuances between different jurisdictions. The discussion also incorporates Davis’ criteria, essential for assessing responsibility in stress- and violence-related deaths.
Conclusion: The need for interdisciplinary collaboration is emphasized to accurately assess the medical causes of death and their legal implications. Emphasis is placed on improving post-mortem diagnostics and strengthening the attribution of legal responsibility for more effective management of medico-legal cases and better understanding by healthcare professionals and judicial authorities.
Keywords: Myocardial rupture – Myocardial infarction – Davis criteria – Stress – Criminal responsibility.
