In a suspected drowning case, the forensic pathologist performs Gettler's test by measuring chloride concentrations in blood from the right and left ventricles of the heart. Which result would MOST strongly support a diagnosis of freshwater drowning?

• A Chloride concentrations are equal in both ventricles
• B Chloride concentration in the right ventricle is at least 25% lower than in the left ventricle
• C Chloride concentration in the left ventricle is at least 25% lower than in the right ventricle ✓
• D Chloride concentration in the left ventricle is at least 25% higher than in the right ventricle

Explanation

In freshwater drowning, hypotonic water enters the lungs and is absorbed into the pulmonary circulation, diluting the blood in the left heart. Gettler's test compares chloride levels: in freshwater drowning, left ventricular blood is diluted, showing significantly lower chloride (at least 25% less) than right ventricular blood. In saltwater drowning, the opposite occurs as hypertonic seawater draws fluid into the alveoli, concentrating the left heart blood and raising left ventricular chloride.

Reference: Reddy's The Essentials of Forensic Medicine and Toxicology, 34th ed.

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Written and medically reviewed by the StethoPrep medical team.