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Natural Death

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Forensic Imaging

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Natural death is the end result of an illness or internal failure of the body, which leads to death at some point. The most common cause of natural death worldwide is ischemic heart disease, followed by stroke, chronic respiratory disease, and pneumonia. In contrast to the clinical setting, however, natural deaths investigated for forensic purposes mostly consist of sudden or unexpected events, especially in younger individuals. This is because death investigations and autopsy dissections are rarely performed in the majority of natural deaths, as death is already expected, especially in the elderly ones or in patients with known disease. Sudden death is an unexpected natural death occurring within 24 hours after onset of symptoms, and sudden cardiac death (SCD) is defined clinically as cardiac death occurring within an hour following onset of acute symptoms. The most frequent cause of sudden death is a cardiovascular disease related to atherosclerotic coronary artery disease. Other types of cardiovascular disease that may cause sudden death include hypertrophic cardiomyopathy, coronary artery anomaly and dissection, and aortic aneurysmal rupture and dissection. Non-cardiac diseases, such as cerebrovascular disease, asthma, pulmonary embolism, and intraabdominal hemorrhage, may also lead to sudden death (Levy AD, Harcke J. Essentials in Forensic Imaging, 1st Edition, 2020 CRC Press). In cases of suspected natural death, post-mortem CT (PMCT) can also accurately detect fatal hemorrhages, such as intracerebral hemorrhage and hemopericardium, and easily depict abnormal gas accumulations, such as air embolism, free air in the body cavity, and soft tissue emphysema. Furthermore, PMCT angiography enables comprehensive visualization of the vascular system and pin-points the sites of vascular rupture or occlusion in cases of unexpected natural death, such as aortic disease or SCD. Currently, these techniques have been shown to play useful roles in screening for potential causes of natural death and guiding tailored dissection of the suspected area for visual demonstration, which would be sometimes difficult or time-consuming by standard dissection alone.

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Acknowledgment

The authors would like to thank the medical examiners in NFS Korea for their advice and help in preparation of this chapter.

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Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon, Republic of Korea

    Heon Lee & Jang Gyu Cha

  2. Department of Forensic Medicine, National Forensic Service, Gangwon, Republic of Korea

    Heon Lee, Sookyoung Lee, Taehwa Baek, Jang Gyu Cha & Kyung-moo Yang

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  1. Heon Lee
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  2. Sookyoung Lee
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  3. Taehwa Baek
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  4. Jang Gyu Cha
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  5. Kyung-moo Yang
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Editors and Affiliations

  1. Service de médecine légale, CHU Rangueil, Toulouse, France

    Fabrice Dedouit

  2. Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Heidelberg, Germany

    Kathrin Yen

  3. Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Heidelberg, Germany

    Sarah Heinze

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Lee, H., Lee, S., Baek, T., Cha, J.G., Yang, Km. (2022). Natural Death. In: Dedouit, F., Yen, K., Heinze, S. (eds) Forensic Imaging. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-83352-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-83352-7_11

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  • Online ISBN: 978-3-030-83352-7

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