Li Wenhe, Zhang Lin, Liang Yue, Tong Fang, Zhou Yiwu
Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Techology, PR China.
Medicine (Baltimore). 2017 Jan;96(1):e5688. doi: 10.1097/MD.0000000000005688.
Atrioventricular node (AVN) contusion usually results in cardiogenic shock and arrhythmia and is a rare but fatal condition. The condition is difficult to diagnose and easily overlooked because it develops rapidly and is asymptomatic. We here report 3 cases that demonstrate blunt chest impact and hemorrhages of the posterior atrioventricular junction, eventually result in death.
Autopsy and histological examination were performed on all cases. External inspection revealed bruises in the hearts and fractures in the sternum and ribs. However, histological examinations were conclusive and showed cardiac contusion on the surface of the posterior atrioventricular junction of the individuals, and the death was due to the AVN contusion. The position of the AVN on the heart surface is determined by detailed examinations via an autopsy and microscopic, both of which are critical in the certification of cause of death.
The report is intended to raise our understanding and make forensic pathologists aware of the surface of the posterior atrioventricular junction.