Blunt trauma to the heart: The pathophysiology of injury

Nirgiotis, Jason G.; Colón, Rolando; Sweeney, Michael S.

doi:10.1016/0736-4679(90)90459-9

Cited by 25 publications

(13 citation statements)

References 62 publications

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“…Accordingly, the trauma has to occur during the systole to affect the atria and in diastole to affect the ventricles. 57 Cardiac lacerations that do not result in death of the animal can heal with fibrous scars; these can potentially lead to dysrhythmias as can also occur subsequent to contusions.…”

Section: Thoracic Cavitymentioning

confidence: 99%

See 1 more Smart Citation

Blunt Force Trauma in Veterinary Forensic Pathology

2016

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Veterinary pathologists commonly encounter lesions of blunt trauma. The development of lesions is affected by the object's mass, velocity, size, shape, and angle of impact and by the plasticity and mobility of the impacted organ. Scrape, impact, and pattern abrasions cause localized epidermal loss and sometimes broken hairs and implanted foreign material. Contusions are best identified after reflecting the skin, and must be differentiated from coagulopathies and livor mortis. Lacerations-traumatic tissue tears-may have irregular margins, bridging by more resilient tissue, deviation of the wound tail, crushed hairs, and unilateral abrasion. Hanging or choking can cause circumferential cervical abrasions, contusions and rupture of hairs, hyoid bone fractures, and congestion of the head. Other special forms of blunt trauma include fractured nails, pressure sores, and dog bites. Ocular blunt trauma causes extraocular and intraocular hemorrhages, proptosis, or retinal detachment. The thoracic viscera are relatively protected from blunt trauma but may develop hemorrhages in intercostal muscles, rib fractures, pulmonary or cardiac contusions or lacerations with subsequent hemothorax, pneumothorax, or cardiac arrhythmia. The abdominal wall is resilient and moveable, yet the liver and spleen are susceptible to traumatic laceration or rupture. Whereas extravasation of blood can occur after death, evidence of vital injury includes leukocyte infiltration, erythrophagocytosis, hemosiderin, reparative lesions of fibroblast proliferation, myocyte regeneration in muscle, and callus formation in bone. Understanding these processes aids in the diagnosis of blunt force trauma including estimation of the age of resulting injuries.

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Section: Thoracic Cavitymentioning

confidence: 99%

“…These must be differentiated from infarcts in which the hemorrhage is usually less marked. 57 Areas of contusion can progress to necrosis and repair, creating areas of weakness that can develop into abnormal structures such as aneurysms and may be prone to rupture. 70 Heart lacerations are described in human forensic pathlogy.…”

Section: Thoracic Cavitymentioning

confidence: 99%

Blunt Force Trauma in Veterinary Forensic Pathology

2016

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“…This lack of cellular damage differentiates myocardial concussion from myocardial contusion. The latter results in structural damage similar to that of acute myocardial infarction [9]. However, one may assume that pathologic changes of the heart wall probably do occur since the observed clinical consequence cannot be explained as purely functional.…”

Section: Discussionmentioning

confidence: 96%

Child Homicide Caused by Commotio Cordis

Boglioli

Taff²,

Harleman

1998

Pediatr Cardiol

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Cardiac concussion, previously known as commotio cordis, occurs in structurally normal hearts without gross or microscopic injury to the myocardium, cardiac valves, or coronary arteries, as opposed to other sports-related deaths known to occur more frequently in structural or congenital heart disease. We describe the sudden cardiac death of a 2-year-old child, who died as a result of a blunt force impact to the chest. A thorough medicolegal investigation was necessary to determine that the child died as a result of foul play.

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“…There are no generally accepted diagnostic criteria for myocardial contusion [2,4,6,9,10,12,15]. Patients exhibit precordial pain that is unaffected by breathing.…”

Section: Discussionmentioning

confidence: 99%