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Published in: Forensic Science, Medicine and Pathology 3/2021

01-09-2021 | Suicide | Images in Forensics

Fatal bleeding after transfemoral coronary angiography in anorexia nervosa

Authors: Inga Duval, Elke Doberentz, Burkhard Madea

Published in: Forensic Science, Medicine and Pathology | Issue 3/2021

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Abstract

In 2015, 911,841 left heart catheterizations and 365,038 percutaneous coronary interventions were carried out in Germany. Complication rates for elective cardiac catheterization are low; however, the risk of complications increases with patient age and comorbidity. We present the case of a 49-year-old woman with long-term anorexia nervosa who underwent a diagnostic left heart catheterization on suspicion of takotsubo cardiomyopathy (TTC). She was found with extended hemorrhage from the puncture site approximately 3.5 h after the procedure. Autopsy identified fatal bleeding as the cause of death. Clinical examinations, autopsy findings, and forensic follow-up examinations revealed no pre-existing conditions that could have contributed to fatal bleeding. Anorexia nervosa is an eating disorder with a high mortality rate. Suicide is one of the most frequent causes of death among anorexia nervosa patients. Considering the patient’s history of psychiatric problems and previous suicidal utterances, we assume that she manipulated her pressure bandage with suicidal intent.
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Metadata
Title
Fatal bleeding after transfemoral coronary angiography in anorexia nervosa
Authors
Inga Duval
Elke Doberentz
Burkhard Madea
Publication date
01-09-2021
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 3/2021
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-021-00354-4

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