Autopsy study on subendocardial haemorrhage in fatal non cardio-thoracic trauma cases

852 Medico-legal autopsies undertaken in the Department of Forensic Medicine, Kasturba Medical College Manipal, during a period of recent 5 years (1992-1997). Of these, there were 33 non-cardio-thoracic trauma cases with a distinct zone of Subendocardial haemorrhage in the septal wall of the left ventricle. Among these, 17 cases (51,5%) died of head injuries. Regarding other injuries resulting in death 21.2% were due to multiple injuries (excluding cardio-thoracic injuries). Drug or chemical intoxication death constituted 12.1%. Miscellaneous causes including bums and hanging in this study accounted for 15.2%. The time between injury and death varied considerably. In 12 cases (36:4%) the interval was 10 hours, while in two cases (6.1%) it was less than 01 hour. Among the drug/or chemical related fatalities there were 2 cases of insecticide poisoning and 1 case of Barbiturate poisoning. Among the miscellaneous causes there were 4 cases of fatal burns and 2 case of hanging. The results of the study are consistent with the hypothesis that cardiac lesion could be secondary to non- cardiovascular injuries, especially with the head injuries, which are perhaps mediated by hypersecretion of catacholamines. It also adds to the fact that the cardiac lesions are likely to be the part of mechanism of death. Secondary cardiac lesions are also important with reference to heart transplantation, as these lesion, especially when the donor is a victim of head injury via catacholamine hypersecretions, may act adversely in transplant recipient.