DIFFERENTIAL DIAGNOSIS OF DEATH FROM HYPOTHERMIA AND SUDDENLY APPEARED HEART DISEASE BY MICROMORPHOLOGICAL SIGNS

Abstract

The problem of differential diagnosis of death from hypothermia is rather urgent due to the fact that in forensic practice deaths in low temperature conditions can be either from hypothermia or from other causes, such as sudden heart disease. The article is based on the results of a sectional, histological and statistical studies of 55 corpses of people who have died from acute hypothermia (general hypothermia) and 14 died from sudden heart disease, (5 of them from ischemic heart disease, 9 from alcoholic cardiomyopathy). Pathomorphological picture of the cardiovascular system during hypothermia is described, but diagnostic and differential diagnostic value of its elements as well as their relationship with the variants of tanatogenesis is unclear.The authors propose a set of characteristics, statistically allowing to differentiate these causes of death: signs, characterizing therate of dying, early signs of respiratory distress-syndrome, features of acute circulatory disorders, the character and severity of acute damage to cardiomyocytes and neurons, the spectrum of the background chronic diseases and manifestations of chronic stress. Initial manifestations of respiratory distress syndrome in hypothrmia and their diagnostic significance are being described for the first time. In addition, the article presents explanations and proofs of pathogenesis and diagnostic value of signs described in the literature previously.The result of our study was the identification of several new signs of death characteristic of sudden heart disease and hypother-mia, as well as the determination of their diagnostic significance.