Fatal Suicidal Cut-Throat Wound in a Patient With Double Valve Replacement: Interplay of Cardiac Dysfunction and Self-Harm

TL;DR

A 32-year-old man with a history of heart valve surgery died from a self-inflicted neck wound, highlighting the complex link between chronic illness and suicide.

Contribution

This case highlights the interplay between cardiac dysfunction and self-harm in a patient with a history of double valve replacement.

Findings

The patient's pre-existing cardiac condition likely accelerated the fatal outcome from the neck wound.

The incised wound showed hesitation cuts but no defensive injuries, suggesting a deliberate act.

The cause of death was determined to be hemorrhagic shock.

Abstract

Suicidal incised neck injuries are infrequent and exhibit considerable forensic intricacies, particularly when compounded by pre-existing medical conditions. We delineate a case involving a 32-year-old male patient diagnosed with severe rheumatic heart disease and a history of double valve replacement, who succumbed to a self-inflicted incised neck wound during his hospitalization. The 7.5-cm incised wound presented two skin tags, indicative of hesitation cuts, and was devoid of any defensive injuries. The internal examination indicated an enlarged heart, artificial heart valves in situ, a pale appearance of the organs, and haemorrhagic infiltration around the wound; anatomical parts like the trachea and oesophagus were intact. The mechanism of mortality was ascribed to be haemorrhagic shock. The patient's impaired cardiac function likely contributed to the expedited fatal outcome by restricting physiological compensatory mechanisms. This case exemplifies the complex interaction between chronic illness and suicidal tendencies, underscoring the need for comprehensive forensic analysis and proactive mental health assessments in individuals with medical vulnerabilities.

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