Ölüm Nedeninin Tespitinde Yardımcı Bir Bulgu Diagonal Kulak Lobu Çizgisi

Koroner arter hastal›klar›, doal sebeplerle meydana gelen olum nedenlerinin bafl›nda gelmektedir. Bu hastal›klar›n yuk- sek insidans ve mortalite oranlar›, bilinen risk faktorlerinden cok, olas› risk faktorlerinin araflt›r›lmas›n› gerekli k›lm›flt›r. Bir fizik muayene bulgusu olan diagonal kulak lobu cizgisi (DKLC), 1973 y›l›nda tan›mlanm›flt›r. Cal›flmam›zda, DKLC'nin, olu muayenesi yapan hekim icin olum nedeninin tespitinde yard›mc› bir bulgu olup olamayaca¤›n›n saptanmas› amaclanm›flt›r. Cal›flmam›z›n bulgular›, vakalara uygulanan anjiografiler so- nucunda; a. coronaria sinistra?n›n dallar› olan ramus interven- tricularis anterior (RIA) ve ramus circumflexus (RC) ile a. co- ronaria dextra'da (ACD) saptanan daralma yuzdeleri artt›kca DKLC gorulme s›kl›¤›n›n da artt›¤›n› gostermektedir. Bu du- rum DKLC ve koroner arter hastal›klar› aras›nda anlaml› ilifl- kiler bildiren daha onceki cal›flmalar›n bulgular› ile uyumlu- dur. Ozellikle oykuye ulaflma olana¤› bulunmayan ve herhangi bir travmatik bulgu saptanmayan vakalarda DKLC'nin, olu- mun koroner arter hastal›¤›ndan meydana geldii yonunde des- tekleyici bir bulgu olarak muayeneyi yapan hekimin dikkatini cekmesi gereken bir iflaret olduunu duflunmekteyiz. Anahtar kelimeler: Diagonal kulak lobu cizgisi, koroner ar- ter hastal›¤›, olu muayenesi. Coronary artery disease is a major cause of natural death. The high incidence and mortality of these diseases arised a need to investigate possible risk factors beyond well known. Diagonal ear lobe crease (DEC), was the physical sign, descri- bed in 1973. We investigated the possibility of DEC as a help- ful predictive sign in the postmortem examination of forensic sudden death cases. The angiographic results revealed that whenever the percen- tages of the stenosis in left descending coronary artery, cir- cumflex artery and right coronary artery increased, the inci- dence of the DEC did so accordingly. These results were corre- lated with the previous studies reporting significant correlation between coronary artery disease and the DEC. Particularly, in the absence of supportive medical history and without a physical sign of trauma, the presence of DEC co- uld well be a supportive sign for the physician to consider the coronary artery disease as a cause of death.