HEART - Myocardial bruising secondary to resuscitation attempts

This is a small heart, opened to display subendocardial haemorrhage, most marked beneath the posterior cusp of the mitral valve.
This 22-year-old woman was found collapsed at home. She had a history of epilepsy, which was not being treated as the fits were infrequent. On the day of her death, she had undergone conservative dental treatment, for which she had been partly sedated with Valium. At 6.40pm on the day of her death she was well and seen sitting on a couch. A few minutes later she was found lying face down, and was heard to make gurgling noises. She was cyanosed, and appeared to be pulseless. Resuscitation was attempted, and was continued by the ambulance team, but she had cardiac and respiratory arrest on admission to hospital, and finally, she had a further convulsion followed by a respiratory arrest some twelve hours later.