# Fatal Injuries Following Aggressive Cardiopulmonary Resuscitation in a Young Woman

## TL;DR

A 44-year-old woman died after CPR caused severe injuries, revealing the risks of aggressive resuscitation and the importance of distinguishing trauma timing in forensic analysis.

## Contribution

This case highlights fatal CPR-related injuries and the need to differentiate ante-mortem from post-mortem trauma in forensic evaluations.

## Key findings

- Autopsy showed multiple rib fractures, sternum fracture, and aortic tear from CPR.
- Histopathology confirmed undiagnosed atherosclerosis and coronary artery hypoplasia as the immediate cause of death.
- No vital reaction at injury margins indicated the trauma occurred post-mortem.

## Abstract

Cardiopulmonary resuscitation (CPR) is a complex of emergency procedures aimed at restoring vital functions in individuals experiencing cardiac arrest. Despite its life-saving potential, CPR can result in a range of injuries, from minor abrasions to severe, life-threatening trauma. This vignette case details the sudden death of a 44-year-old woman who suffered extensive intra-thoracic and intra-abdominal injuries during CPR. Although these injuries were severe, the immediate cause of death was acute coronary artery failure as a result of undiagnosed atherosclerosis and coronary artery hypoplasia. The woman collapsed at a social event and received telephone-assisted CPR from her intoxicated boyfriend, followed by professional resuscitation efforts. Autopsy revealed multiple rib fractures, sternum fracture, pleural hemorrhage, lung contusions, and aortic tear, alongside significant internal bleeding. The histopathological examination confirmed the presence of atherosclerosis and coronary artery hypoplasia, and, crucially, revealed the absence of a vital reaction at the margins of the traumatic injuries. This case highlights the paradoxical nature of CPR, where life-saving efforts can simultaneously cause significant harm. It also emphasizes the importance of considering CPR-related injuries during forensic examinations in order to determine the cause of death accurately. The findings contribute to the limited body of literature on fatal CPR-associated injuries and stress the need for awareness among medical professionals regarding the potential for such outcomes, particularly emphasizing the vital distinction between ante-mortem and post-mortem trauma.