Cardiac inhibitory reflex as a cause/mechanism of death

J Forensic Sci. 2013 Nov;58(6):1644-7. doi: 10.1111/1556-4029.12212. Epub 2013 Jun 20.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrioventricular Block / complications
  • Baroreflex / physiology*
  • Heart Arrest / etiology
  • Heart Arrest / physiopathology*
  • Humans
  • Laryngoscopy / adverse effects
  • Male
  • Neck Injuries / physiopathology
  • Syncope, Vasovagal / etiology
  • Syncope, Vasovagal / physiopathology*
  • Traction / adverse effects