Evaluation of Cases with Hemopericardium Detected at Autopsy; A Retrospective 5-Year Case Analysis

Abstract

Objective:
Cardiac tamponade secondary to hemopericardium is among the leading causes of sudden cardiac death. It is characterized by the accumulation of blood within the pericardial cavity, resulting in compression of the cardiac chambers and hemodynamic instability. This study aimed to evaluate the etiological factors, predisposing conditions, and morphological characteristics of hemopericardium cases, which represent an important subgroup of sudden cardiac deaths.

Materials and Methods:

A retrospective review was conducted on autopsy cases with hemopericardium performed at the Morgue Department of the Ankara Group Presidency of the Council of Forensic Medicine over a 5-year period. A total of 126 cases were examined for age, sex, body mass index (BMI), evidence of previous myocardial infarction (MI), hemopericardium volume, presence of aneurysm, left ventricular wall thickness, heart weight, coronary artery characteristics, medical history, and location of death.

Results:
Of the 126 cases, 93.6% (n = 118) were non-traumatic and 6.3% (n = 8) were traumatic in origin. Among non-traumatic cases, 77.1% (n = 91) were male and 22.8% (n = 27) female. Ventricular rupture following early-phase myocardial infarction was identified as a major risk factor for hemopericardium, while age was determined to be an independent parameter associated with increased risk.

Conclusion:
These findings suggest that routine histopathological staging of myocardial infarction during autopsies may improve diagnostic accuracy in determining the etiopathogenesis of hemopericardium. Furthermore, the development of early diagnostic and clinical follow-up strategies for post-infarction cardiac tamponade is of critical importance.