Journal of Forensic and Legal Medicine
Volume 17, Issue 6 , Pages 339-343 , August 2010

Cardiac injuries in car occupants in fatal motor vehicle collisions – An autopsy-based study

  • Elisabeth E. Turk, MD

      Affiliations

    • Universität des Saarlandes, Homburg, Germany
    • Corresponding Author InformationCorresponding author. Institut für Rechtsmedizin, Universität des Saarlandes, Gebäude 42, 66421 Homburg a. d. Saar, Germany. Tel.: +49 6841 1626319; fax: +49 6841 1626314.
    • ,
  • Yee-Wah Tsang, MD

      Affiliations

    • Birmingham Heartlands Hospital, Birmingham, UK
    • ,
  • Anisha Champaneri, MD

      Affiliations

    • Russells Hall Hospital, Dudley, UK
    • ,
  • Klaus Pueschel, MD

      Affiliations

    • Institute of Legal Medicine, University of Hamburg, Germany
    • ,
  • Roger W. Byard, MD

      Affiliations

    • Discipline of Pathology, The University of Adelaide, Australia

Received 23 June 2009 ,Revised 31 March 2010 ,Accepted 13 May 2010.

References 

  1. Brathwaite CE, Rodriguez A, Turney SZ, Dunham CM, Cowley R. Blunt traumatic cardiac rupture: a 5-year experience. Ann Surg. 1990;212:701–704
  2. Byard RW. Shoulder–lap seatbelts and thoracic transaction. J Clin Forensic Med. 2002;9:92–95
  3. Byard RW, Noblet H. Child booster car seats and lethal seat belt injury. J Paediatr Child Health. 2004;40:639–641
  4. Cachecho R, Grindlinger GA, Lee VW. The clinical significance of myocardial contusion. J Trauma. 1992;33:68–71
  5. Campbell BJ. Safety belt injury reduction related to crash severity and front seat position. J Trauma. 1987;27:733–739
  6. Chughtai TS, Gilardino MS, Fleiszer DM, Evans DC, Brown RA, Mulder DS. An expanding role for cardiopulmonary bypass in trauma. Can J Surg. 2002;45:95–103
  7. Conroy C, Hoyt DB, Eastman B, Holbrook TL, Pacyna S, Erwin S, et al. Motor vehicle-related cardiac and aortic injuries differ from other thoracic injuries. J Trauma. 2007;62:1462–1467
  8. Duda AM, Ilada PB, Molnar RG, Bachulis BL. Successful repair of blunt cardiac rupture involving both ventricles. Cardiovasc Surg. 1999;7:263–265
  9. Ferjani M, Droc G, Dreux S, Arthaud M, Goarin JP, Riou B, et al. Circulating cardiac troponin T in myocardial contusion. Chest. 1997;111:427–433
  10. Galan G, Penalver JC, Paris F, Caffarena JM, Blasco E, Borro JM, et al. Blunt chest injuries in 1969 patients. Eur J Cardiothoracic Surg. 1992;6:284–287
  11. Hitosugi M, Ishihara T, Takatsu A, Shigeta A. Prediction of injuries to the heart and thoracic aorta in unrestrained drivers. Leg Med. 2002;4:103–108
  12. James RA, Byard RW. Asphyxiation from shoulder seat belts. An unusual motor vehicle injury. Am J Forensic Med Pathol. 2001;22:193–195
  13. Kahane C. Fatality reduction by airbags: analyses of accident data through early 1996. Washington, DC: National Highway Traffic Safety Administration; 1996;
  14. Kavoulis J, Golocovsky M, Champion HR. Predictors of outcome in patients who have sustained trauma and who undergo emergency thoracotomy. Arch Surg. 1993;128:1158–1162
  15. Koehler SA, Shakir A, Ladham S, Rozin L, Omalu B, Dominick J, et al. Cardiac concussion: definition, differential diagnosis, and cases presentation and the legal ramification of a misdiagnosis. Am J Forensic Med Pathol. 2004;25:205–208
  16. Loo GT, Siegel JH, Dischinger PC, Rixen D, Burgess AR, Addis MD, et al. Airbag protection versus compartment intrusion effect determines the pattern of injuries in multiple trauma motor vehicle crashes. J Trauma. 1996;41:935–951
  17. Marshall D, Gilbert J, Byard RW. The spectrum of findings in cases of sudden death due to blunt cardiac trauma – ‘commotio cordis’. Am J Forensic Med Pathol. 2008;29:1–4
  18. Matthes G, Schmucker U, Lignitz E, Huth M, Ekkernkamp A, Seifert J. Does the frontal airbag avoid thoracic injury?. Arch Orthop Trauma Surg. 2006;126:541–544
  19. McGillycuddy D, Rosen P. Diagnostic dilemmas and current controversies in blunt chest trauma. Emerg Med Clin North Am. 2007;25:695–711viii–ix
  20. McGwin G, Metzger J, Alonso JE, Rue LW. The association between occupant restraint systems and risk of injury in frontal motor vehicle collisions. J Trauma. 2003;54:1182–1187
  21. Meluzin J, Groch L, Toman J, Hornacek I, Fischerova B. Rupture of the coronary artery after blunt nonpenetrating chest wall trauma detected by color Doppler echocardiography: a case report. J Am Soc Echocardiogr. 2000;13:1043–1046
  22. Michalodimitrakis EN, Tsatsakis AM. Vehicular accidents and cardiac concussion: a traumatic connection. Am J Forensic Med Pathol. 1997;18:282–284
  23. Moulin A, Bason-Mitchell M, Henderson SO. Cardiac contusion diagnosed by cardiac troponin. Am J Emerg Med. 2002;20:382–383
  24. Peden M, Scurfield R, Sleet D, Mohan D, Jyder A, Jarawan E, et al. World report on road traffic injury prevention. Geneva: World Health Organization; 2004;
  25. Riches KJ, James RA, Gilbert JD, Byard RW. Fatal childhood vascular injuries associated with seat belt usage. Am J Forensic Med Pathol. 2002;23:45–47
  26. Richter M, Krettek C, Otte D, Wiese B, Stalp M, Ernst S, et al. Correlation between crash severity, injury severity, and clinical course in car occupants with thoracic trauma: a technical and medical study. J Trauma. 2001;50:10–16
  27. RuDusky BM. Classification of myocardial contusion and blunt cardiac trauma. Angiology. 2007;58:610–613
  28. Salim A, Velmahos GC, Jindal A, Chan L, Vassiliu P, Belzberg H, et al. Clinically significant blunt cardiac trauma: role of serum troponin levels combined with electrocardiographic findings. J Trauma. 2001;50:237–243
  29. Sethi D, Racioppi F, Bertollini R. Preventing the leading cause of death in young people in Europe. J Epidemiol Community Health. 2007;61:842–843
  30. Sevitt S. The mechanisms of traumatic aortic rupture of the thoracic aorta. Br J Surg. 1977;64:166–173
  31. Siegel JH, Smith JA, Siddiqi SQ. Change in velocity and energy dissipation on impact in motor vehicle crashes as a function of the direction of crash: key factors in the production of thoracic aortic injuries, their pattern of associated injuries and patient survival. A Crash Injury Research Engineering Network (CIREN) study. J Trauma. 2004;57:760–777
  32. Turk EE, Tsokos M. Blunt cardiac trauma caused by fatal falls from height: an autopsy-based assessment of the injury pattern. J Trauma. 2004;57:301–304
  33. Vignon P, Boncoeur MP, Francois B, Rambaud G, Maubon A, Gastinne H. Comparison of multiplane transesophageal echocardiography and contrast-enhanced helical CT in the diagnosis of blunt traumatic cardiovascular injuries. Anesthesiology. 2001;94:615–622

PII: S1752-928X(10)00084-3

doi: 10.1016/j.jflm.2010.05.005

Journal of Forensic and Legal Medicine
Volume 17, Issue 6 , Pages 339-343 , August 2010

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