Blow/trauma to the chest and sudden cardiac death: Commotio cordis and contusio cordis are leading causes. (April 2018)

• Record Type: Journal Article
• Authors: Krexi, Lydia; Sheppard, Mary N
• Is Part Of: Medicine, science and the law. Volume 58:Number 2(2018)
• Page Start: 93
• Page End: 96
• Publication Date: 2018-04
• Subjects: Commotio cordis -- contusio cordis -- sudden death -- trauma -- blow to the chest; Forensic sciences -- Periodicals; Medical laws and legislation -- Great Britain -- Periodicals; 614.105
• DOI: 10.1177/0025802418754961
• Languages: English
• ISSNs: 0025-8024

Abstract

Background: In forensic practice, a blow to the chest can lead to sudden cardiac death (SCD). Commotio cordis and contusio cordis are leading causes. Methods: From a database of 4678 patients who suffered from SCD, we found three patients with commotio cordis and two patients with contusio cordis. All the patients were examined macroscopically and microscopically and had negative toxicology screen. Results: The three patients who died due to commotio cordis were young males (16, 23 and 38 years old). The circumstances of death were: a blow to the chest by a football, by a friend during a party and during an assault. The hearts were completely normal at autopsy. The two patients who had contusio cordis were older males (42 and 63 years old). Both patients died during traffic accidents. At autopsy, one had significant contusion over the left ventricle, and the second had contusion over the right ventricle. Conclusion: This study indicates that a blow to the chest is very important to document in the circumstances of death, and a detailed history is vital. It raises the left ventricular intra-cavitary pressure, leading to commotio cordis with immediate death with a normal heart. Blunt chest trauma can cause direct myocardial lesions, with acute changes leading to contusio cordis.