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Cardiac Inhibitory Reflex as a Cause/Mechanism of Death
Authors:Jose M Suárez‐Peñaranda MD  PhD  Cristina Cordeiro MD  Marisol Rodríguez‐Calvo MD  PhD  Duarte N Vieira MD  PhD  Jose Ignacio Muñoz‐Barús MD  PhD
Institution:1. Department of Pathology and Forensic Science, University of Santiago de Compostela, , Santiago de Compostela, Spain;2. National Institute of Legal Medicine and Forensic Sciences of Portugal, Centre Branch, , Coimbra, Portugal;3. Centre of Forensic Sciences (CENCIFOR), University of Coimbra, , Coimbra, Portugal;4. Institute of Forensic Science, University of Santiago de Compostela, Rúa San Francisco s/n, , 15782 Santiago de Compostela, Spain
Abstract:The role of cardiac inhibitory reflex as a potential cause of death is still a matter of debate. This study reports two cases of death under unusual circumstances. Case 1 corresponds to a man found hanging where the role of ligature compression of the carotid sinus became relevant as a possible explanation of death. In Case 2, the participation of a vasovagal syncope was clearly triggered by the laryngoscopic procedure. It is proposed that cardiac inhibitory reflex should be taken into account in those cases of unexpected death, which fulfills the following three criteria: (i) The investigation of the circumstances of the death is consistent with a hypothesis of cardiac arrest. (ii) A typical triggering peripheral stimulus is present. (iii) The performance of a complete autopsy cannot rule out the participation of a cardiac inhibitory reflex in the cause of death.
Keywords:cardiac inhibitory arrest  carotid sinus stimulation  forensic science  vasovagal syncope
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