Sudden death from myocardial contusion following an isolated blunt force trauma to the chest

Abstract

Cardiac contusion is a common concomitant injury in blunt, non-penetrating chest trauma and is mostly a benign disorder which remains undiagnosed. In the case presented, a young man sustained a single blunt trauma to the chest from falling pieces of a wooden wheel and died at the scene. Among other findings, the autopsy revealed a circumscribed detachment of the coronary arteries on the anterior side of the heart. The most unusual findings were lacerations of the vessel wall layers in these areas which could already be seen at the autopsy and were proven by histological examination.

Rupture of heart with all layers after a massive blunt thoracic trauma without any lesion on the bones: a case report

“…Penetrative injuries result in organ laceration in many cases. [8] The incidence of cardiac laceration in patients with blunt thoracic trauma has been reported in various studies as 2%, [9] more than 7%, [10,11] and more than 15%. [12,13] Cardiac rupture because of one blunt thoracic trauma is very rare.…”

“…costae and sternum fractures). [5,10] This type of injury has a wide range of clinical expression, from no clinical finding to serious life-threatening findings like arrhythmia, conduction anomalies, congestive heart failure, cardiogenic shock, hemo-pericardium, pericardial tamponade, valvular rupture, intraventricular thrombus, thromboemboli, air emboli, coronary artery occlusion, ventricular aneurysm, and constructive pericarditis. [12,13] Blunt thoracic traumas causing cardiac rupture have a high mortality rate.…”

“…Because the right ventricle wall is thinner than the left, right ventricle injury is more frequent. [10] Aorta rupture incidence is 13-16% in traffic accidents, and mortality rate in these cases is 70-85%. [16] Cardiac injury frequently occurs in traffic, sportive and occupational accidents and due to intentional trauma.…”

“…Recently, blunt cardiac injuries have mostly resulted from traffic accidents. [3,[10][11][12]17] Cardiac injuries have been found to occur more frequently with penetrative injury than with blunt injury. [12] A few cases of simultaneous rupture of mitral and tricuspid valves caused by blunt chest trauma have been reported.…”

Cardiac Contusion: Unsolved Problems of Theory and Practice

“…Столь значительный разброс значений показателя объясняется нечеткостью термина [9], сложностью диагностики [9,10], зачастую минимальными клиническими проявлениями [11], в связи с чем диагноз может опаздывать на годы [12] или даже остается не диагностированным [13].…”