Tattoli Lucia, Maselli Eloisa, Romanelli Maria Carolina, Di Vella Giancarlo, Solarino Biagio
J Forensic Sci. 2014 Mar;59(2):564-7. doi: 10.1111/1556-4029.12340.
Chest skeletal injuries are the most frequent complications of external chest massage (ECM) during cardiopulmonary resuscitation, but heart and great vessels lacerations that are indeed very rare. We report the case of a 35-year-old workman who collapsed and underwent ECM by his co-workers for almost 30 min. At autopsy, no external injuries, fractures or bruises of the ribs or sternum, were observed. A hemopericardium with a rupture of the heart was found, with no signs of pre-existent cardiac disease. Bruises of thoracic aortic wall, lung petechiae, a contusion of the liver, and bruises of lumbar muscles were found. The cause of death was due to sudden cardiac death with an extensive cardiac rupture. This is an unusual report of massive heart damage without any skeletal or muscle chest injuries, secondary to cardiopulmonary resuscitation. This kind of cardiac lesions may be considered when thoracic–abdominal trauma, or medical history, is unclear.
胸部骨骼损伤是心肺复苏期间胸外按压（ECM）最常见的并发症，但心脏和大血管撕裂伤确实非常罕见。我们报告了一名35岁工人的病例，他突然晕倒，同事对其进行了近30分钟的胸外按压。尸检时，未观察到肋骨或胸骨的外部损伤、骨折或瘀伤。发现心包积血伴心脏破裂，无既往心脏病迹象。发现胸主动脉壁瘀伤、肺瘀点、肝脏挫伤和腰肌瘀伤。死因是心脏广泛破裂导致的心源性猝死。这是一例不寻常的报告，即心肺复苏后继发严重心脏损伤但无任何胸部骨骼或肌肉损伤。当胸腹部创伤或病史不明时，可能会考虑这种心脏病变。
