Correctly assessing heart weight can be critical at postmortem examination. The current international guidelines advocate using the short‐axis method in dissecting the heart and the heart weighed when the blood is emptied. However, it did not specify at what point the heart should be weighed or how the blood should be emptied. This study compared heart weights at three different time points during the heart examination (immediately after dissecting out of the pericardial sac with blood still in chambers, blood washed/removed from heart chambers without the heart opened, and the heart completely opened, blood emptied, and pad dried). This was to illustrate the variation in measurement and potential errors when the heart is weighed at different time of dissection. The results show that there were statistical and clinical significant differences between the heart weights at each weighing points. We recommend the heart to be completely dissected with any blood and residual washing/rinsing water emptied before being weighed. Although performed in this study, the effect of pad drying the heart on heart weight was not explored and was a limitation in this study.

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Heart weight is routinely measured at postmortem examination and is critical to determine whether the heart is enlarged (ie, cardiomegaly). Cardiomegaly has the potential to cause sudden death by being electrically unstable, resulting in fatal arrhythmias. The majority of fatal cardiac arrhythmias is ventricular in origin and is assumed that ventricular size is disproportionately larger in cardiomegaly. This prospective study compared ventricular weight (VW) and total heart weight (THW) in 40 consecutive cases. The results, unexpectedly, showed that VW increases proportionally and linearly with THW in normal and enlarged hearts (THW, >500 g) and did not increase disproportionally with increased THW. The ratio of VW/THW did not have any significant correlation or difference with sex, height, weight, and cardiac causes of death but did have a negative correlation with age. Further studies are indicated to document the morphological changes when the heart enlarges, which may aid in understanding the pathophysiology of sudden death from cardiomegaly.

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non-winter seasons. This case documents a hypothermic death in a setting of morbid obesity and subsequent liver failure and cardiomegaly where widespread Wischnewsky lesions and slightly elevated beta-hydroxybutyrate were noted, with nonelevated blood sugar levels. In this rare case, the only identifiable predisposing factor to hypothermia was metabolic derangement resulting in altered energy metabolism.

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During hypothermia, alteration of glucose metabolism can result in a hyperglycaemic and ketoacidotic state. 1 Conversely, diabetic ketoacidosis (DKA) can precipitate hypothermia by impaired thermoregulation and autonomic dysfunction. 2 Both DKA and hypothermia can demonstrate overlapping pathological and biochemical findings. 3 Aim: Due to the related pathophysiology between hypothermia and DKA, we hypothesised that were would be a higher number of deaths from DKA in winter than in any other season. Method: We performed a 12-year retrospective study on all deaths related to DKA at the Department of Forensic Pathology, Auckland City Hospital, New Zealand. The decedents' age and sex, and the season they died, were recorded. Statistical analysis was performed using R statistics. Results: A total of 35 cases were included. Age and sex were not statistically significant between the seasons. Winter had the highest number of deaths from DKA (n=12), followed by summer (n=9), autumn (n=8) and spring (n=6). Discussion: This study demonstrated that winter months had the highest number of deaths from DKA compared to other seasons. Given the similar pathophysiology and pathologic findings between hypothermia and DKA, this implies that winter may be a factor that can precipitate or exacerbate DKA that may be under recognised.Obesity is an increasingly prevalent co-morbidity that is associated with sudden unexpected death and is commonly encountered in post mortem practice. Due to the effects of increased body-habitus it is, however, uncommon to encounter a death in an obese individual from hypothermia, especially during S102 PATHOLOGY 2020 ABSTRACT SUPPLEMENT Pathology (2020), 52(S1)