Child Homicide Caused by Commotio Cordis

Boglioli, Lauren R.; Taff, Mark L.; Harleman, G.

doi:10.1007/s002469900347

Cited by 30 publications

(13 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By contrast, it has also been suggested as underlying an extra cardiac phenomenon described as "commotio cordis" or cardiac concussion (17), in which a blunt impact to the front of the chest produces arrhythmic death without structural damage, often in children or young adults during sports injuries (1,24). It also occurs in adults and can have medicolegal implications (2,10).…”

mentioning

confidence: 99%

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Chen

Penny

Greve

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

Regional mechanical and electrophysiological changes accompany most ventricular arrhythmias and, it has been suggested, by mechanoelectric feedback. We hypothesized that an intervention producing regional mechanical dispersion was associated with regional, proarrhythmic electrical dispersion and studied the regional mechanoelectric feedback in the right ventricle (RV) of anesthetized lambs. Ten lambs were deeply anesthetized, and their hearts were exposed. Three tripodal devices, each incorporating three monophasic action potential electrodes and an integrated strain-gauge system, were placed on the RV apex outflow and inflow regions. Measurements were made before, during, and after 10-s pulmonary arterial occlusion. Pulmonary arterial occlusion increased RV pressure and overall regional segment length. Length excursion became out of phase with RV pressure beats immediately after occlusion, and the strain patterns were different in the three regions at the peak of occlusion. The occlusion resulted in different alterations in regional monophasic action potential morphology, including reduction in monophasic action potential amplitude and duration by different amounts and early afterdepolarizations that were unevenly distributed in the monophasic action potential recordings. This was associated with dispersion of repolarization and recovery time. The combination of electromechanical events precipitated a variety of arrhythmias. Acute RV distension is proarrhythmic, possibly through a causal relationship among mechanically induced afterdepolarizations, dispersion (heterogeneity) of mechanical strain, and dispersion of electrical recovery. The relationship among the different wall motions, the dispersion of repolarization, and arrhythmia underscored mechanoelectric feedback as an important part of arrhythmogenesis in pulmonary embolism and commotio cordis.

show abstract

mentioning

confidence: 99%

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Chen

Penny

Greve

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

show abstract

“…11 Different criteria have been proposed by multiple research teams. Maron et al 12 suggested the flowing inclusion criteria for commotio cordis from 128 confirmed cases: (1) a witnessed blunt, non-penetrating blow to the chest immediately preceding cardiovascular collapse; (2) detailed documentation of the circumstances from available newspaper articles, police reports and telephone interviews with family members or other witnesses; (3) absence of structural damage to the sternum, ribs and heart itself; and (4) absence of any underlying cardiovascular abnormalities. The present victim collapsed immediately after suffering from a blunt blow to the chest within several minutes, which was similar to other victims.…”

Section: Discussionmentioning

confidence: 99%

Imprudent blow, catastrophic consequence: a case of commotio cordis associated with violence

et al. 2012

View full text Add to dashboard Cite

Commotio cordis is a rare and catastrophic mechano-electric feedback syndrome, and it is especially apt to occur in male children, adolescents and youths during sports activities. The authors present a case of unexpected sudden death due to commotio cordis associated with violence. In a house of detention, a 19-year-old boy was punched and kicked in the face, neck and chest during a fight with another suspect in their ward. Unfortunately, his precordium was the major injured region. The victim turned pale, then lost the ability to resist and lost consciousness immediately. When the emergency medical personnel arrived, the victim was found in a condition of cardiac and respiratory arrest and he was pronounced dead at the scene without cardiopulmonary resuscitation. Both autopsy signs and forensic morphology were in accord with the criteria for commotio cordis diagnosis, showing no cardiac or other organic fatal lesions and no underlying cardiac diseases; moreover, the toxicological screening was negative for alcohol, drug and common toxicants. In the present case, the whole fight was seen by some witnesses in their ward, and it was recorded by the monitoring unit. Based on the statements of the witnesses and the monitoring videotape, combined with the forensic pathological and toxicological examinations, all the testimonies supported the conclusion that the cause of death was commotio cordis.

show abstract

“…Link and colleagues found that a normal baseball with 40 mph/sec was apt to trigger ventricular fibrillation compared to the same baseball with 70 mph/sec, which mainly lead to recruitment of stretch-activated ion channels during the 15-30 msec window prior to the T-wave in the cardiac cycle (3,5). Most decedents due to commotio cordis were men and showed a predilection for children and adolescents (1,9,10). In the current cases, both decedents were exactly 15-year-old males.…”

Section: Discussionmentioning

confidence: 99%

Commotio Cordis – A Report of Two Similar Cases

Zheng

Liang

Liu

et al. 2012

Journal of Forensic Sciences

View full text Add to dashboard Cite

Commotio cordis is a rare and fatal mechano-electric arrhythmogenic syndrome, occurring mainly during sports activities. The present study describes two similar cases of sudden death caused by commotio cordis associated with homicide. The two decedents were both 15-year-old male teenagers. Both collapsed within several minutes after being punched in the precordial region, as observed by witnesses at the scenes. Although electrocardiograms were not recorded at the scenes or the hospitals, the sudden onset of cardiovascular, respiratory, and neural symptoms were consistent with sudden cardiac death caused by commotio cordis. Autopsy and forensic morphology both revealed no cardiac or pericardiac structural damage, evident lesions of other internal organs, or underlying diseases, along with negative toxicological analysis, conforming to criteria for diagnosis of commotio cordis. The diagnosis of commotio cordis by forensic pathologists is important in deliberating a verdict of homicide, especially involuntary homicide. In rare instances, a death caused by commotio cordis may have a homicide manner of death.

show abstract

Child Homicide Caused by Commotio Cordis

Cited by 30 publications

References 11 publications

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Imprudent blow, catastrophic consequence: a case of commotio cordis associated with violence

Commotio Cordis – A Report of Two Similar Cases

Contact Info

Product

Resources

About