Cyanotic heart
Cyanotic heart as a result of hanging - a classic forensic medicine case! Here are petechial hemorrhages seen on the epicardium of the heart. Petechiae (pinpoint hemorrhages) represent bleeding from small vessels and are classically found when a coagulopathy is due to a low platelet count. They can also appear following sudden hypoxia due to asphyxia and deprivation of blood supply (ischemia), thus confirming this case was a suicide by hanging. On postmortem examinations, there are non-specific physical signs used to attribute death to asphyxia. These include visceral congestion via dilation of the venous blood vessels and blood stasis, petechiae, cyanosis and fluidity of the blood. Notice the bluish vessels on the surface of the heart. The loss of oxygen is the reason veins are described as blue since they carry blood that has lost oxygen to the body's cells back to the lungs where it can be reoxygenated. As asphyxia progresses and more oxygen is depleted, a dark discoloration of the skin and tissues called cyanosis develops.
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