Forensic Cardiovascular Medicine

I. OVERVIEW OF FORENSIC MEDICINE

Introduction and Philosophy

Death Certificates, Autopsies, and Medical

Experts

II. CARDIAC TRAUMA

Myocardial Contusion and Blunt

Cardiac Trauma

Overview

Mechanism of Blunt Cardiac Injury

Pathology of Contusion

Forensic Consideration

Symptoms

Signs

Diagnosis

Consequences of Blunt Cardiac Trauma

III. VASCULAR ABNORMALITIES

Coronary Arterial Afflictions

Introduction

Coronary Artery Disease

Vascular Injury

Aortic Aneurysms and Aortic Dissection

Nonpenetrating Vascular Injury

Nontraumatic Vasculopathies

Coagulopathic Disorders

Basic Coagulation Defects

Heparin-Induced Thrombocytopenia

Additional Coagulation Commentary

Mesenteric Ischemia

IV. SPECIFIC CARDIOPATHIC DISORDERS

Pericardial Problems

Valvular Heart Disease

Cardiac Tumors

Cardiomyopathic Disorders

VI. TOXIC AND PHYSICAL INFLUENCES

Cardiotoxicity

General Pharmacologic and Physical Overview

Cocaine

Alcohol

Physical Agents

Androgenic Steroids

Carbon Monoxide

Particulate Air Pollution

Radiation Therapy

Medication-Induced Cardiac Valvulopathy

Drug-Induced Electrocardiographic Changes

VII. TECHNICAL, EPIDEMIOLOGIC, SOCIAL

AND PHILOSOPHICAL INFLUENCES

The Electrocardiogram

Stress

VIII. ILLUSTRATIVE CASE REPORTS

Case Reports

Case 1: Blunt Chest Trauma Resulting in Traumatic Tricuspid Insufficiency

Forensic Implications

Case 2: Myocardial Contusion, Cardiac Rupture, and

Sudden Death

Forensic Implications

Case 3: Acute Myocardial Infarction in the Very Young

Forensic Implications

Case 4: Nitrate Holiday

Forensic Implications

Case 5: Thoracic Aortic Aneurysm

Forensic Implications

Case 6: Total Aortic Dissection

Forensic Implications

Case 7: Abdominal Aortic Aneurysm, Dissection, and Rupture

Forensic Implications

Case 8: Temporal Arteritis

Forensic Implications

Case 9: Disseminated Intravascular Coagulation and

Heparin-induced Thrombocytopenia

Forensic Implication

Case 10: Postoperative Drug-induced Hemorrhage

Patient 1

Patient 2

Forensic Implications

Case 11: Acute Mesenteric Ischemia (Arterial)

Forensic Implications

Case 12: Subacute and Chronic Mesenteric Ischemia

Forensic Implications

Case 13: Superior Mesenteric Vein Thrombosis

Forensic Implications

Case 14: Pericardial Tamponade

Forensic Implications

Case 15: Toxic Myocarditis from an "Herbal Energy Capsule"

Forensic Implications

Case 16: Left Atrial Myxoma

Forensic Implications

Case 17: Vascular Metastatic Obstruction — Arterial Obstruction Secondary to Metastatic Chondrosarcoma

Forensic Implications

Case 18: Oncologic Cardiomyopathy

Forensic Implications

Case 19: Idiopathic Dilated Cardiomyopathy

Forensic Implications

Case 20: Brugada Syndrome

Forensic Implications

Case 21: Carcinoid Syndrome

Forensic Implications

Case 22: Stress-Induced Myocardial Infarction

Forensic Implications

Case 23: Pulmonary Embolism

Forensic Implications

Case 24: Radiation-Induced Cardiac Disease

Forensic Implications

Case 25: Carbon Monoxide Toxicity

Forensic Implications

Appendices

References

Biography

Basil RuDusky

"Today's medical legal issues have created an intense climate among the medical, legal, and judicial professions. Using his vast experience in the medical legal theater, Dr. RuDusky addresses a very complicated field in a simple and concise manner. Stressing the importance of honesty, integrity, and accuracy of data, he provides an insightful and interesting approach to the problems facing today's medical community. ... will become a must-read for medical practitioners and legal experts."

--John H. Ellis, IV, M.D., F.A.C.C., Chairman, Department of Cardiology, Wyoming Valley Healthcare System and Wilkes-Barre General Hospital

"As a beginning Resident in Internal Medicine, I feel that Dr. RuDusky's book ...  is a must-read for any new and training physician. I especially found the section on "Illustrative Case Reports" to be significant since they are not topics normally stressed in basic medical education. I now understand why Dr. RuDusky is considered to be a medical expert in his own right."

--Damien M. Marycz, M.D., Internal Medicine Resident, Cleveland Clinic

"Dr. RuDusky has always been fair, impartial, logical, and concise in his analysis of my medical negligence cases. This book adds significantly to a better understanding of the complex medicine behind his opinions."

--Robert K. Randall, Prominent Midwest malpractice attorney

"As an experienced civil trial attorney in New Jersey, I must say the material contained in the ideas surrounding and underlying this book are significant and would represent a major contribution for use by physicians, physicians' students, lawyers, and judges connected with the field of forensic medicine in many different contexts. I would look forward to receiving and using a completed copy of this publication."

--Michael D. Schottland, Prominent Eastcoast malpractice attorney

 

"The book under review is a unique resource for medical and medico legal professionals. … Dr. Basil RuDusky has had a vast experience in dealing with medico legal cases dealing with cardiovascular trauma, and in this book, he draws upon his experiences to churn out a masterpiece. … Perhaps the most illustrative part of the book is section VII, which gives as many as 25 illustrative case reports … This book is the very first which deals with forensic and medico legal aspects of cardiovascular medicine. In my opinion, it is an absolute must for all medical and medico legal professionals and medical examiners."

—Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology