engleski

Self-induced stress death – the unexpected outcome of suicide attempt

Introduction. The term psychical trauma (also called stress deaths) is the impairment of health condition caused by intensive emotional experience. The causes may differ but all share the strong state of excitement that is created rapidly and is of relatively short duration but strong intensity regardless of whether it is a joy, sorrow or fear. This concept helps forensic pathologist to explain cases of death occurring as the consequence of emotionally charged situations, possibly involving physical interaction between the victim and the stressor, on the persons with preexisting organic cardiac disease. Basis of the mechanism is neurohumoral connection between the central nervous and cardiovascular systems. As stated, such events regularly require the activity of other person or environmental situation. However, the question arises whether such emotional stress can be self-induced. Case. Sixty-year old man was found dead in his apartment locked from the inside. The scene included the presence of two kitchen knives near the body, cutting wounds on the wrist and suicide note, clearly suggesting the suicidal manner of death. However, autopsy revealed that the wounds were only superficial and not affecting any major blood vessel. Accordingly, the amount of blood found near the body was estimated as being minimal. On the other hand, the finding that dominated at internal examination was the advanced atherosclerosis of coronary arteries with marked cardiac hypertrophy and myocardial scars. Toxicological analysis was negative, apart from sub-therapeutic level of verapamil. Death was ruled as violent, due to psychical trauma caused by the attempt of suicide. Discussion and conclusion. Although considered as being precipitated by some external event, stress death can exceptionally occur by person’s own activity and independently from emotional stimuli originated from the outer world. In the above case, suicide attempt by one mean has turned to lethal outcome caused by the stress accompanied with presuicidal activities.

stress death; psychical trauma; suicide attempt

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