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The orientation of the decedent with the tire of the motor vehicle apparently compressing the midsection and with the corresponding vascular changes (congestion versus petechiae) support a scenario in which there was hampered venous return to the heart. As this would lead to impaired respiration, this is considered a form of mechanical asphyxia.

Fig.1 Mechanical asphyxia.

Mechanical asphyxia occurs when external forces or mechanical obstructions prevent normal breathing, leading to oxygen deprivation and potentially fatal outcomes. Causes include strangulation, chest compression, or airway obstruction, which physically block airflow or compress blood vessels, stopping oxygen from reaching vital organs. Unlike suffocation from a lack of breathable air, mechanical asphyxia specifically involves pressure on the neck, chest, or airways. This can result from accidents, physical restraint, or intentional acts. The lack of oxygen disrupts brain and organ function, leading to loss of consciousness and, if prolonged, can cause irreversible brain damage or death.

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