Savall Frederic, Dedouit Fabrice, Telmon Norbert, Rougé Daniel
Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, 31059, Toulouse Cedex 9, France.
J Forensic Sci. 2013 Nov;58(6):1648-50. doi: 10.1111/1556-4029.12207. Epub 2013 Aug 23.
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.
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。
