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.