doiSerbia

Cardiac tamponade due to rupture of healed and sealed aortic intimomedial tear: Case report

Nikolić Slobodan (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Atanasijević Tatjana (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Popović Vesna (Institut za sudsku medicinu, Medicinski fakultet, Beograd)

Introduction: The healed and sealed intimomedial aortic tears showed clearly defined edges and U-shaped defect of the tissue extending from intima into the media of a varying depth, filled by paler tissue with smooth surface. These tears can be solitary or multilocular, localized in different parts of the aorta, followed by limited intramural incomplete dissection. They can be provoked by diseases or injury. This part of the aortic wall filled with scar tissue is very vulnerable and could be the site of new rupture, followed by tamponade or fatal internal bleeding. Case outline. In this paper, we report a case of unexpected unknown death of a young male, 26-years-old, found on the ground, near his car. At autopsy, we established the old healed and open intimomedial tear on the posterior wall of the ascending aorta, with a remaining little dissection flap. This part of the wall with scar tissue was ruptured, causing bleeding in the pericardial sac, and tamponade. Histologically, the early stage of cystic medial degeneration was recognized. There were no injuries of the skin, soft tissue and bones. Conclusion. In the paper, we discussed the manner of death in this case, as well as the medicolegal implications. .

Keywords: healed tear, aorta, intimomedial tear, arterial dissection