Death of a 23-year-old man from cardiac conduction system injury through a blunt chest impact after a car accident

• Published in: Egyptian journal of forensic sciences Vol. 4; no. 4; pp. 137 - 139
• Main Authors: Zerbo, S., Maresi, E., Portelli, F., Sortino, C., Ventura Spagnolo, E., Procaccianti, P., Argo, A.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2014; SpringerOpen
• Subjects: Blunt chest trauma; Car accident; Cardiac conduction system injury; Cardiac contusion; Forensic pathological diagnosis; Forensic pathological diagnosis; Car accident; Cardiac conduction system injury; Blunt chest trauma; Cardiac contusion
• ISSN: 2090-536X; 2090-5939
• DOI: 10.1016/j.ejfs.2014.08.003

Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent causes of cardiac contusion resulting from a direct blow to the chest. Myocardial contusion is difficult to diagnose; the clinical presentation varies greatly, ranging from a lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. The authors report a case of death due to a cardiac conduction system injury from a blunt chest impact following a car accident. The autopsy showed no external signs of thoracic trauma, no evident rib or sternum fractures. A small sub-endocardial hemorrhage was found in the region of the atrioventricular node. Histological examination revealed an injury of the atrioventricular node and His’ bundle. The cause of the death was attributed to the arrhythmia induced by contusion of the cardiac conduction system.