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一起抢劫案后一名珠宝商发生的应激性心肌病:法医学考量

Takotsubo cardiomyopathy in a jeweler following a hold-up: forensic considerations.

作者信息

Savall Frederic, Dedouit Fabrice, Telmon Norbert, Rougé Daniel

机构信息

Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31059, Toulouse Cedex 9, France.

出版信息

J Forensic Sci. 2013 Nov;58(6):1648-50. doi: 10.1111/1556-4029.12207. Epub 2013 Aug 23.

Abstract

The authors present a case of takotsubo cardiomyopathy (TTC) following physical assault. In France, public prosecutor orders a medicolegal assessment after an assault for all living victims. Medicolegal assessment aims to establish a causal relation between an aggression and the injury sustained. An 80-year-old jeweler was the victim of assault, restraint and confinement during the hold-up of his jewelry store. After the event, he experienced constrictive chest pain with a sensation of oppression. Transthoracic echography showed apical and middle wall akinesis with apical ballooning pattern. In this case, the experts reasonably accepted that there was a direct, certain, and exclusive causal relation between the aggression and the cardiomyopathy. Forensic specialists should be aware of TTC because it is a frequent complication of stress situations and its incidence in forensic cases is probably underestimated.

摘要

作者报告了一例身体攻击后发生的应激性心肌病(TTC)病例。在法国,对于所有在世的暴力袭击受害者,检察官会下令进行法医学评估。法医学评估旨在确定攻击行为与所受伤害之间的因果关系。一名80岁的珠宝商在其珠宝店被抢劫时遭受了攻击、约束和拘禁。事件发生后,他经历了压榨性胸痛并伴有压迫感。经胸超声心动图显示心尖和室壁中部运动减弱,呈心尖气球样改变。在该病例中,专家合理地认定攻击行为与心肌病之间存在直接、确定且唯一的因果关系。法医专家应了解应激性心肌病,因为它是应激状态下常见的并发症,且在法医案件中的发生率可能被低估。

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