Forensic Point-of-Care Test to Unveil the Cause of Death in Sudden Cardiac Deaths: A Case Series

Abstract

This forensic case series from the central region of India, to the best of our knowledge, signifies a paradigm shift, leveraging point-of-care testing (POCT) to swiftly unravel the mysteries of sudden cardiac deaths. The autopsy series integrates the SD Biosensor F2400 Analyzer (Suwon, South Korea) device and POCT cartridges, centering on cardiac troponin I (cTnI) and creatine kinase-myocardial band (CK-MB). Across four diverse cases, intricate details emerge, weaving a complex tapestry of trauma and cardiovascular pathology. In Case 1, a fatal road accident unveils air embolism and head injury intricacies. Case 2 delves into breathlessness, exposing myocardial infarction complexities. Revisiting Case 3 reveals sudden collapses' challenges, emphasizing acute cardiac nature through cTnI and CK-MB values. Case 4 intertwines head injury complexities with cardiac involvement, accentuating the delicate balance between trauma and cardiac pathology. The discussion navigates through case nuances, underlining the cost-effectiveness and time efficiency of POCT. Comparative analyses with existing literature showcase POCT's uniqueness in autopsy examinations. Challenges in discerning antemortem changes from postmortem alterations underscore the need for meticulous analysis. In conclusion, this series showcases the potential of POCT in revolutionizing forensic pathology and providing rapid, reliable diagnostic insights into sudden cardiac deaths.

Keywords: cardiac biomarkers; ck-mb; forensic biochemistry; forensic medicine; forensic pathology; legal medicine; point-of-care testing (poct); sudden cardiac death; troponin i.