Images in Cardiothoracic Medicine and Surgery

Cardiac rupture due to blunt chest trauma: postmortem findings in two cases

Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(8) 996 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313501313 aan.sagepub.com

Ahmet Kupeli1, Isa Dongel2 and Mustafa Demirer1

Figure 1. Photographs showing the transmural laceration of the left ventricle (white arrows).

Figure 2. Photographs showing the transmural laceration of the right atrium (white arrows).

Blunt traumatic cardiac rupture is associated with high mortality and usually identified at autopsy. Two women aged 47 and 86 years-old died immediately after motor vehicle accidents. In the first case, autopsy revealed fractures of the bilateral clavicula, multiple bilateral ribs, and the body of the sternum. Massive hemothorax was present in the pleural cavity. An oblique transmural laceration measuring 6 cm in length was observed in the left ventricle 1.5 cm above the cardiac apex (Figure 1). In the other case, autopsy showed massive hemothorax in both pleural cavities and fractures in multiple bilateral ribs, the body of the sternum, and the manubrium sterni. A transmural laceration in the back of the right atrium, measuring 1.8  0.8 cm, was

also observed (Figure 2). Cardiovascular injuries represent the second most common cause of traumatic death, after central nervous system injuries. Few patients survive to reach hospital. One should keep in mind blunt cardiac rupture in a patient with severe chest trauma. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest statement None declared.

1 Department of Forensic Medicine, Su¨leyman Demirel University, Medical Faculty, Isparta, Turkey 2 Department of Thoracic Surgery, Su¨leyman Demirel University, Medical Faculty, Isparta, Turkey

Corresponding author: Isa Dongel, MD, Department of Thoracic Surgery, Su¨leyman Demirel University Medical Faculty, Isparta, Turkey. Email: [email protected]

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Cardiac rupture due to blunt chest trauma: postmortem findings in two cases.

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