The significance of subendocardial hemorrhages detected in forensic autopsies

Abstract

Introduction: In our study, our aim was to reveal the relationship between subendocardial hemorrhage (SEH) which can be seen macroscopically immediately beneath the endocardium, and emerges secondary to many conditions from direct cardiac, head and abdominal traumas to hyperemia, and its location with cause of death, its diagnostic value (if any), and whether it can be evaluated as a vital finding. Material and Method: 285 autopsy cases diagnosed as SEH, which were brought to the Council of Forensic Medicine of Turkey, Bursa Morgue Department, Bursa, Turkey were included in the study. Results: Study population consisted of 229 (80.4%) male and 56 (19.6%) female patients. Thity-one cases of death were related to natural causes, while the most frequently detected pathological causes of death were isolated abdominal traumas (32.9%), followed by isolated head traumas (31.9%). While traffic accidents ranked first (35.1%) among the events leading to death. Among the evaluated cases, SEH was mostly located on the septum. Discussion: To fully understand the yet inadequately elucidated pathogenic mechanisms of SEH, it should be accurately defined by histopathological analysis. Even though various causes of death seen in association with these lesions suggest more than one underlying pathogenic mechanism, because of their nonspecific characteristics, their possible roles as indicators of vitality (if any) should be reinforced by further studies.