Unusual self-inflicted fatal cardiac injury with a knitting needle: a case report

Abstract Background Using penetrating objects in the chest and abdomen is still an uncommon method for suicide, especially among elderly people. Knives are the most common instrument used in committing suicide by this method. Unconventional instruments like a knitting needle are rarely used. This rare case highlights an unusual method of suicide using a knitting needle for chest penetration in an elderly man. Case presentation An 88-year-old man was found dead in his closed apartment with no signs of struggle or disturbance. Multiple puncture wounds were found on the left side of the chest and in the inguinal region. A knitting needle fixed with a clamp and stained with blood was found near the body. Autopsy revealed the presence of 32 puncture wounds in the chest, 21 of which reached the heart. Histopathology showed myocardial infiltration with erythrocytes, macrophages, and polymorphonuclear cells. Toxicological analysis was negative for alcohol, narcotics, and psychoactive drugs. No psychiatric or medical history that contributed to a suicidal risk was identified. Conclusion This case highlights the role of comprehensive forensic investigations to distinguish between homicidal and suicidal acts, especially with such an unusual instrument. It also raises awareness about suicide in the elderly, even without psychiatric and medical risks or indicators.