Undetermined Natural Causes

At least 1-2% of the deaths in a busy forensic jurisdiction will be undetermined and a majority of those will be due to natural causes. The autopsy will be negative. The pathologist will be unable to find a cause of death after a complete autopsy that includes microscopic and toxicological studies. Such decedents tend to be younger individuals who have had no previous injuries or medical problems. The mechanism of death in these cases must be an arrhythmia of the heart; however, the cause cannot be determined.

Staf Infection The Breast
FIGURE 5.1 These are hearts that have been injected with dye postmortem. The heart on the left has normal undamaged coronary arteries. The heart on the right has narrowed blood vessels (arrows) due to atherosclerosis (hardening of the arteries).
Autopsy Gunshot Wounds
FIGURE 5.3 The earliest noticeable signs of a heart attack is dark colored muscle (arrows). This discoloration reveals the heart attack to be hours old at the time of death. © 2000 CRC Press LLC
FIGURE 5.2 These cross-sections of coronary arteries are plugged with atherosclerotic disease (hardening of the arteries). The arrows point to the only openings (dark areas) in the vessels. The yellow material is the atherosclerosis.
Yellow Discoloration Walls
FIGURE 5.4 This heart shows the yellow discoloration of a heart attack which is approximately a week old (arrows).
Gunshot Wound Images
FIGURE 5.5 This is the inside of the left ventricular heart wall showing the white scarring from an old heart attack.
Gunshot Wound Scar

FIGURE 5.6 An old heart attack will appear as a white scar on the outside of the heart wall (arrows).

White Clot Atherosclerosis

FIGURE 5.7 The complications of heart attacks include a rupture of the heart wall (black arrow) and the formation of a blood clot (white arrow).

FIGURE 5.6 An old heart attack will appear as a white scar on the outside of the heart wall (arrows).

FIGURE 5.7 The complications of heart attacks include a rupture of the heart wall (black arrow) and the formation of a blood clot (white arrow).

Pictures Ruptured Veins Legs
FIGURE 5.8 Coronary bypass. The arrows reveal the veins that have been used to jump across the plugged coronary arteries. The veins usually come from the legs.
Gunshot Wounds
FIGURE 5.9 This man was discovered in a recreation center. His position suggests a sudden collapse and death. See next photo.
Gunshot Wound
FIGURE 5.10 His clothes had been removed and neatly placed on the bench. See next photo.
Obese Man Attacks
FIGURE 5.12 This obese man died suddenly. The arrow points to the dark and thickened skin of the lower legs, which is a sign of poor circulation and heart disease.
Granulomatous Slack SkinPoor Circulation Lower Legs

ure. This heart (between the arrows) is more than twice the FIGURE 5.16 A cross-section of the heart in the previous size of normal. See next photo. photo would look like this. The chambers are dilated and the walls are thinner than normal.

ure. This heart (between the arrows) is more than twice the FIGURE 5.16 A cross-section of the heart in the previous size of normal. See next photo. photo would look like this. The chambers are dilated and the walls are thinner than normal.

Enlarged Heart Due Alcohol Abuse

FIGURE 5.17 Obese individuals have enlarged hearts and are FIGURE 5.18 An enlarged heart from obesity or high blood prone to die suddenly. See next photo. pressure (top) may be twice the size of normal (bottom).

FIGURE 5.17 Obese individuals have enlarged hearts and are FIGURE 5.18 An enlarged heart from obesity or high blood prone to die suddenly. See next photo. pressure (top) may be twice the size of normal (bottom).

Gunshot Wounds
FIGURE 5.19 The wall (arrows) in this cross-section is very thick. This is a sign of hypertension (high blood pressure).
Gunshot Wound Images
FIGURE 5.20 This is a normal aortic valve. See next photo.
Gunshot Wound Images
FIGURE 5.22 Normal mitral valve. See next photo.
Gunshot Wound
FIGURE 5.24 The metal probe is sticking through a ventricular septal defect (opening) which is a congenital abnormality which can cause sudden death.
Gunshot Aortic Arch
FIGURE 5.21 This aortic valve has vegetations of bacteria (arrows) from possible chronic drug abuse. Compare with previous photo.
Leaflets Abuse
FIGURE 5.23 Abnormal mitral valve with thickened leaflets. This is a "ballooning" mitral valve which caused sudden death. Compare with previous photo.
Death Gunshot
FIGURE 5.25 This is another septal defect in a three-week-old child who occasionally stopped breathing and would turn blue. The defect was not detected at birth or upon regular check-ups.
Images Gunshot Wound ChildrenImages Gunshot Wound Children

FIGURE 5.26 The aortic arch in this child was congenitally narrowed. The upper arrow shows the constriction. The lower arrow points to the aortic valve.

FIGURE 5.27 This is the lower part of the aorta which shows advanced atherosclerotic disease. A normal aorta should be thin and yellow (arrow). This aorta is thickened and has so much wall damage it is prone to rupture.

Gunshot Wounds
FIGURE 5.28 This aorta ruptured into the bowel and caused sudden death by bleeding. The initial body examination might show bleeding from the rectum

FIGURE 5.29 This lady's left leg is more swollen than the right. Blood clots in the legs will cause them to swell. A blood clot can break loose, travel through the heart, and plug up the blood vessels in the lungs. See next photo.

FIGURE 5.27 This is the lower part of the aorta which shows advanced atherosclerotic disease. A normal aorta should be thin and yellow (arrow). This aorta is thickened and has so much wall damage it is prone to rupture.

Black Blood Clots LegsRight Lung More Prone Than Left
FIGURE 5.30 This swollen leg was opened to reveal the dark blood clots (thrombi) in the calf muscle vessels (arrows).
Blood Clot Calf
FIGURE 5.31 Pulmonary thromboemboli. Blood clots (arrow) have broken away from the legs and traveled up the body to lodge in the large blood vessels of the lungs. This caused chest pain and sudden death.
Gun Shot Wound The Leg
FIGURE 5.32 This lung has abundant black pigment (anthra-cosis) on its surface. The person with this lung either smoked or worked in a coal mine.
Broken Blood Vessels Calf

FIGURE 5.33 These lungs have dramatic emphysema with balloon-type expansions on their surfaces (arrows). This means the lung tissue has been destroyed (usually from smoking) and the person has difficulty getting oxygen into the lungs.

FIGURE 5.34 This lung has smaller holes than the previous case. This sponge-like appearance is also typical for advanced chronic emphysema.

Emphysema Hole Lung
FIGURE 5.35 Another presentation of emphysema showing the holes in the lungs caused by smoking. This change causes the right side of the heart to thicken which renders it prone to failure.
Gunshot Wounds
FIGURE 5.38 Ruptured cerebral aneurysm. A ballooned blood vessel ruptured over the bottom of this brain. This caused a marked hemorrhage (subarachnoid) over the base, sides, and top of the brain.
Gunshot Wounds
FIGURE 5.36 This lung has firm white areas (arrows) of pneumonia.
Right Sided Brain Aneurysm
FIGURE 5.37 Sudden death in the bathtub. He ruptured a cerebral (brain) aneurysm.
Human Brain Aneurysm Autopsy
FIGURE 5.39 Another case of marked subarachnoid hemorrhage originating over the base of the brain. Most of these hemorrhages occur naturally from ruptured aneurysms; however, some can be caused by minor trauma or rupture secondary to drugs such as cocaine and methamphetamine.
Gunshot Wound
figure 5.40 This is an aneurysm (ballooned-out blood vessel) which was located on the base of the brain. It ruptured and caused death.
Gunshot Wound
figure 5.42 This area of swelling at the base of the brain was the finding in the sudden death of an eight year old. He complained of a headache the night he died. See next photo.
Methamphetamine And Aneurysms
figure 5.41 The darker masses are cancer of the brain. Brain cancer rarely causes sudden unexpected death, but it may.
Aneurysm Growing Areas

figure 5.43 The pituitary gland rests in this area at the base of the skull. This area is much more expanded than usual due to the growth of a tumor. See next photo.

figure 5.44 This photo of the base of the brain shows the area of the tumor.

figure 5.43 The pituitary gland rests in this area at the base of the skull. This area is much more expanded than usual due to the growth of a tumor. See next photo.

Gunshot WoundGunshot Wound The Breast
figure 5.45 This lady came into the emergency room and died within a few hours. No one knew she had a huge tumor in her abdomen. See next photo.
Huge Tumors
figure 5.46 The tumor was of ovarian origin and it weighed 26 lbs.
Picture Death Due Gunshot
figure 5.47 This is cancer of the breast after treatment. The woman died at home. The cancer had spread (metastasized) throughout her body. Breast cancer is rarely a cause of sudden and unexpected death.
Died Gunshot

figure 5.48 This woman had received treatment for cancer of the lung. There was a hole in her chest wall (arrow) through which the lung could be seen. She died of infection.

Mm figure 5.48 This woman had received treatment for cancer of the lung. There was a hole in her chest wall (arrow) through which the lung could be seen. She died of infection.

Gunshot Wound Lung Liver
figure 5.49 Metastatic cancer to the liver. The white nodules are the cancer.
Gun Shot Hole Through Body
figure 5.50 Marked emaciation. This woman died of starvation.
What Start The Liver Become Damaged
figure 5.52 All of the blood on the floor came from his mouth. He was an alcoholic who had a damaged liver (cirrhosis) which caused blood vessels in the esophagus to become thickened. These thickened vessels (varices) are prone to rupture, as in this case. He bled to death.
Gunshot Wound
figure 5.51 This man collapsed in the bathroom. There was blood on the toilet and the floor. See next photo.
Gunshot Wound
figure 5.53 Chronic alcoholics can also bleed from varices in the rectum.
Gunshot Wound
figure 5.54 This is the distal esophagus in a chronic alcoholic. The arrow points to the thickened varices. The stomach (to the left) is red because of irritation from the alcohol.
Severe Gunshot WoundsWound Pictures
figure 5.56 This illustrates the difference between a cirrhot-ic liver from alcohol abuse (upper) and a normal liver (lower).

figure 5.58 This African-American man developed a severe reaction to antibiotics. This type of injury should not be confused with thermal injury. See next photo.

figure 5.58 This African-American man developed a severe reaction to antibiotics. This type of injury should not be confused with thermal injury. See next photo.

Gunshot Wound
figure 5.59 The outer layer of his skin slipped off most of his body. Some of the skin (arrow) on his chest became mummified while he was alive. See next photo.
Gunshot Wounds
figure 5.60 A closer view of the extent of the damage and the mummification to the chest. See next photo.
Shotgun Spinal Wounds
figure 5.61 The lower extremities were also affected. See next photo.
Stippling Gunshot
figure 5.62 Another case of skin slippage from a reaction to antibiotics. A view of his back reveals the extent of the injury to this African-American man. This change should not be confused with thermal injury.
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Responses

  • reiss
    What Causes Brain Aneurysm?
    7 years ago
  • cora
    What causes an enlarged heart?
    3 years ago
  • abaalom
    How to heal black blood clots?
    2 years ago

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