In a fatal electrocution death, which of the following postmortem internal findings would CONFIRM that current passed through the heart as the mechanism of death, as opposed to respiratory arrest from tetanic respiratory muscle spasm?

• A Presence of an entry and exit mark on the skin confirms cardiac pathway
• B Petechial haemorrhages in myocardium pathognomonically indicate ventricular fibrillation
• C Ventricular fibrillation (VF) cannot be confirmed postmortem; the diagnosis is by exclusion after ruling out other causes, with the current pathway (entry and exit marks) suggesting likelihood of cardiac involvement ✓
• D Coagulative necrosis of the His bundle confirmed on histology is the definitive finding

Explanation

Ventricular fibrillation from electrocution cannot be histologically confirmed postmortem because VF is a functional arrhythmia leaving no specific structural marks. The cause of death in electrocution is diagnosed by exclusion: ruling out other causes with consideration of the current pathway. Entry and exit wounds on left hand–right foot (or vice versa) suggest current passing through the thorax (cardiac pathway), favouring VF as the mechanism. Petechial haemorrhages in the myocardium are nonspecific. Histological changes in conduction tissue from electrocution are inconsistent and not pathognomonic.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.