DROWNING OF A GIRL WITH ANOMALY OF THE BUNDLE OF HIS AND THE RIGHT BUNDLE-BRANCH

We report an unusual case of a 17-year-old girl who died in a filled b athtub. There were at least two attacks of unconsciousness in her prem ortem history. In April 1994, electrocardiography had shown an incompl ete right bundle branch block. At autopsy, unspecific signs of drownin g and hypoplasia of the terminal part of the atrioventricular bundle o f His and the right bundle branch within the cardiac conduction system were found. There were no other obvious autopsy findings related to t he sudden death of this girl. In addition, toxicologic examination for illegal drugs and alcohol was completely negative. We concluded that this might be a rare case of death because of acute decompensation of a partial hypoplastic cardiac conduction system with loss of conscious ness and consequent drowning in the bathtub. This case illustrates the value of an extensive pathologic examination of the cardiac conductio n system in unexpected death of young people.