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Autopsy and Medicine
July 13, 1998

Case of the Month: "Negative" Results of Autopsy and Elusive Cause of Death

Johannes Bjornsson, MD; Randy Hanzlick, MD; and the Autopsy Committee of the College of American Pathologists
Arch Intern Med. 1998;158(13):1399-1400. doi:10.1001/archinte.158.13.1399

A 91-YEAR-OLD man was a nursing home resident mainly due to mild dementia. He died suddenly after taking his evening meal. The nursing home staff reported that he had been in his usual state of health when he suddenly collapsed; death was pronounced within minutes of the collapse. His medical history included nodular goiter diagnosed 27 years prior to death, a 6-year history of atrial fibrillation, and a 4-year history of an unspecified type of mild dementia. Mild mitral regurgitation was also noted 2 years before death. Notably absent from the clinical history was any evidence of systemic hypertension, ischemic heart disease, cerebrovascular disease, or diabetes mellitus.

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