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Heart of glass: fatal hematemesis caused by bronchiole-cardiac fistula

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Abstract

A 58-year old woman presented for autopsy after having been found unresponsive in a public bathroom surrounded by a pool of blood. During attempts at resuscitation, blood was noted in her airway. She had a past medical history that included surgical repair of Tetralogy of Fallot as a child. At autopsy, a shard of glass was identified projecting from the surface of the left lung, having formed densely fibrotic adhesions at the pleural surface. The glass also penetrated through a bronchiole lumen and into a previously surgically repaired bulging right ventricular outflow tract, forming a bronchiole-cardiac fistula, allowing for the massive hemoptysis that led to her death. After further inquiry, it was discovered that the decedent also had a history of seizure disorder and had fallen through a glass door during a seizure many years ago, requiring several shards of glass to be removed from her chest wall.

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Authors and Affiliations

  1. Ontario Forensic Pathology Service, 25 Morton Shulman Avenue, Toronto, Ontario, M3M 0B1, Canada

    Maggie Bellis, Kristopher S. Cunningham & Michael J. Pickup

  2. Department of Laboratory Medicine and Pathobiology, University of Toronto, I King’s College Circle, Toronto, Ontario, M5S 1A8, Canada

    Maggie Bellis, Kristopher S. Cunningham & Michael J. Pickup

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  1. Maggie Bellis
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  2. Kristopher S. Cunningham
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  3. Michael J. Pickup
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Correspondence to Maggie Bellis.

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Bellis, M., Cunningham, K.S. & Pickup, M.J. Heart of glass: fatal hematemesis caused by bronchiole-cardiac fistula. Forensic Sci Med Pathol 17, 334–337 (2021). https://doi.org/10.1007/s12024-020-00320-6

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  • DOI: https://doi.org/10.1007/s12024-020-00320-6

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