Sessa Francesco, Esposito Massimiliano, Messina Giovanni, Di Mizio Giulio, Di Nunno Nunzio, Salerno Monica
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy.
Healthcare (Basel). 2021 Jul 9;9(7):870. doi: 10.3390/healthcare9070870.
The medico-legal term "sudden death (SD)" refers to those deaths that are not preceded by significant symptoms. SD in apparently healthy individuals (newborn through to adults) represents a challenge for medical examiners, law enforcement officers, and society as a whole. This review aims to introduce a useful flowchart that should be applied in all cases of SD. Particularly, this flowchart mixes the data obtained through an up-to-date literature review and a revision of the latest version of guidelines for autopsy investigation of sudden cardiac death (SCD) in order to support medico-legal investigation. In light of this review, following the suggested flowchart step-by-step, the forensic pathologist will be able to apply all the indications of the scientific community to real cases. Moreover, it will be possible to answer all questions relative to SD, such as: death may be attributable to cardiac disease or to other causes, the nature of the cardiac disease (defining whether the mechanism was arrhythmic or mechanical), whether the condition causing SD may be inherited (with subsequent genetic counseling), the assumption of toxic or illicit drugs, traumas, and other unnatural causes.
医学法律术语“猝死（SD）”指的是那些没有明显症状先兆的死亡。在看似健康的个体（从新生儿到成年人）中发生的猝死，对法医、执法人员以及整个社会来说都是一项挑战。本综述旨在介绍一个应适用于所有猝死案例的实用流程图。特别地，该流程图整合了通过最新文献综述以及对最新版心脏性猝死（SCD）尸检调查指南的修订所获得的数据，以支持医学法律调查。鉴于此综述，按照建议的流程图逐步进行，法医病理学家将能够把科学界的所有指示应用于实际案例。此外，将有可能回答所有与猝死相关的问题，例如：死亡可能归因于心脏病还是其他原因，心脏病的性质（确定机制是心律失常性还是机械性），导致猝死的病症是否可能是遗传性的（随后进行遗传咨询），是否服用了有毒或非法药物、是否遭受创伤以及其他非自然原因。
