A man with ischemic heart disease after consuming alcohol found collapsed while eating : a café coronary and intoxication, which cause preceded the others?
| dc.contributor.author | Gangahawatte, S. | |
| dc.contributor.author | Edirisinghe, P. A. S. | |
| dc.contributor.author | Kitulwatte, I. D. G. | |
| dc.date.accessioned | 2024-12-03T06:09:25Z | |
| dc.date.available | 2024-12-03T06:09:25Z | |
| dc.date.issued | 2017 | |
| dc.description.abstract | Introduction Complete and abrupt upper airway obstruction by a bolus of food, with sudden onset of symptoms simulating acute myocardial infarction was described as ‘Café coronary’ in early 60s. Victims are speechless and breathless; thus, without assistance (e.g.Heimlich manoeuvre) they will die. A typical ‘café coronary’ was an obese middle aged man dying, while eating having a chest pain, with eye witness accounts of ‘choking on a piece of meat’ which was hurriedly eaten. Though various theories were postulated at that time regarding the mechanism, later studies showed that multiple factors could be associated. We report a death of an alcoholic with a history of ischemic heart disease found with a bolus of food lodged at the pharynx and larynx. Case Report 51 year-old male after having 11⁄2 bottles of illicit liquor, quarreled with the wife and left home, was found dead two (2) hours later in a partly built house. The examination of the scene revealed half a bottle of alcohol, a partly consumed loaf of bread, a beef curry and a roasted chicken thigh beside. Autopsy revealed obstruction of the mid larynx with a piece of bread, mild laryngeal oedema, myocardial fibrosis, 80% narrowing of the anterior descending artery and a liquor smell from stomach. The toxicological screening revealed 200mg/dlethyl alcohol in the blood, while histology revealed fibrosis of the myocardium. Conclusion Although obstruction of the airway with a food bolus was the apparent cause of death at autopsy, the high blood alcohol level with myocardial fibrosis pauses questions regarding the mechanism of death i.e. which caused which? Therefore, a forensic pathologist should not be hurried to arrive at conclusions during the autopsy without further investigations. | |
| dc.identifier.citation | Sri Lanka Journal of Forensic Medicine, Science & Law May 2017 Vol.8 No.1 P. 4 - 7 | |
| dc.identifier.issn | 2012-7081 | |
| dc.identifier.uri | https://ir.lib.pdn.ac.lk/handle/20.500.14444/4379 | |
| dc.language.iso | en_US | |
| dc.publisher | University of Peradeniya, Sri Lanka | |
| dc.subject | Alcoholic | |
| dc.subject | Ischemic heart disease | |
| dc.subject | Bolus of food | |
| dc.subject | Cafe coronary | |
| dc.title | A man with ischemic heart disease after consuming alcohol found collapsed while eating : a café coronary and intoxication, which cause preceded the others? | |
| dc.type | Article |