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Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case

Blunt chest trauma (BCT) often results in blunt cardiac injuries of little clinical concern, but cases of severe heart damage with high mortality rates have also been described. In particular, BCT should never be underestimated, especially when it is located in the anterior thoracic region. Among tr...

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Autores principales: Gentile, Guendalina, Tambuzzi, Stefano, Giovanetti, Giulio, Zoja, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453835/
https://www.ncbi.nlm.nih.gov/pubmed/33960426
http://dx.doi.org/10.1111/1556-4029.14741
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author Gentile, Guendalina
Tambuzzi, Stefano
Giovanetti, Giulio
Zoja, Riccardo
author_facet Gentile, Guendalina
Tambuzzi, Stefano
Giovanetti, Giulio
Zoja, Riccardo
author_sort Gentile, Guendalina
collection PubMed
description Blunt chest trauma (BCT) often results in blunt cardiac injuries of little clinical concern, but cases of severe heart damage with high mortality rates have also been described. In particular, BCT should never be underestimated, especially when it is located in the anterior thoracic region. Among traffic accidents, motorcyclists are the most vulnerable and at the greatest risk. We report the case of a 14‐year‐old boy who experienced BCT following a motorcycle accident. He was evaluated at the hospital and was found to be in good medical condition, without bruises or rib fractures. Electrocardiography revealed a left bundle branch block. The patient was kept overnight for observation and was discharged the following morning in a good health condition. However, five days later, the patient suddenly died. Autopsy revealed a cardiac contusion associated with a full‐thickness myocardial rupture and massive hemopericardium. Histologically, hemorrhagic infiltration foci, fibrin deposits, neutrophilic granulocytes, and well‐defined areas of necrosis were detected in the context of recent fibrosis. Coronary thrombosis was not observed. The cause of death was identified as cardiac contusion that caused myocardial necrosis and, ultimately, cardiac rupture. Because the boy suffered a recent BCT and was assessed at the hospital, issues of medical malpractice were raised. This case demonstrates the potential lethality of blunt chest trauma in pediatric patients and demonstrates the importance of not underestimating such events, even in the absence of clinically identified chest injuries.
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spelling pubmed-84538352021-09-27 Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case Gentile, Guendalina Tambuzzi, Stefano Giovanetti, Giulio Zoja, Riccardo J Forensic Sci CASE REPORTS Blunt chest trauma (BCT) often results in blunt cardiac injuries of little clinical concern, but cases of severe heart damage with high mortality rates have also been described. In particular, BCT should never be underestimated, especially when it is located in the anterior thoracic region. Among traffic accidents, motorcyclists are the most vulnerable and at the greatest risk. We report the case of a 14‐year‐old boy who experienced BCT following a motorcycle accident. He was evaluated at the hospital and was found to be in good medical condition, without bruises or rib fractures. Electrocardiography revealed a left bundle branch block. The patient was kept overnight for observation and was discharged the following morning in a good health condition. However, five days later, the patient suddenly died. Autopsy revealed a cardiac contusion associated with a full‐thickness myocardial rupture and massive hemopericardium. Histologically, hemorrhagic infiltration foci, fibrin deposits, neutrophilic granulocytes, and well‐defined areas of necrosis were detected in the context of recent fibrosis. Coronary thrombosis was not observed. The cause of death was identified as cardiac contusion that caused myocardial necrosis and, ultimately, cardiac rupture. Because the boy suffered a recent BCT and was assessed at the hospital, issues of medical malpractice were raised. This case demonstrates the potential lethality of blunt chest trauma in pediatric patients and demonstrates the importance of not underestimating such events, even in the absence of clinically identified chest injuries. John Wiley and Sons Inc. 2021-05-07 2021-09 /pmc/articles/PMC8453835/ /pubmed/33960426 http://dx.doi.org/10.1111/1556-4029.14741 Text en © 2021 The Authors. Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle CASE REPORTS
Gentile, Guendalina
Tambuzzi, Stefano
Giovanetti, Giulio
Zoja, Riccardo
Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title_full Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title_fullStr Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title_full_unstemmed Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title_short Sudden death due to cardiac contusion: Forensic implications in a rare pediatric case
title_sort sudden death due to cardiac contusion: forensic implications in a rare pediatric case
topic CASE REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453835/
https://www.ncbi.nlm.nih.gov/pubmed/33960426
http://dx.doi.org/10.1111/1556-4029.14741
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