Differences in Cardiac Rupture and Hemopericardium Caused by Blunt Chest Injury, Acute Myocardial Infarct, Aortic Dissection and CPR

Abstract

Abstract Objective In this study, the hemopericardium volume and pathological characteristics associated with cardiac ruptures caused by blunt violence, AMI, aortic dissection and CPR have been analyzed. The findings might provide reference and data support for deciphering the cause of heart rupture in forensic pathology. Method Pericardial water-injection tests were conducted in 22 noncardiac death subjects. Other study groups included 9 cases of myocardial infarction, 20 cases of aortic dissection rupture, 11 cases of cardiac rupture caused by trauma and 4 cases of cardiac rupture by CPR. The volume of hemopericardium and the pathological features were analyzed for each group. Result The hemopericardium volume in myocardial infarction and dissecting aneurysm rupture were significantly higher than the pericardial injection test in noncardiac subjects (p-value < 0.01). The traumatic cardiac rupture cases had a large range in hemopericardium volume and no significant difference was observed with respect to non-cardiac death cases (p-value > 0.05). The volume of hemopericardium in CPR-induced cardiac rupture had no difference with non-cardiac rupture and it was significantly lower than the pericardial injection test (p-value < 0.01). Conclusion Differences in the volume of hemopericardium induced by different causes of cardiac rupture were observed. It may be related to the state of the cardiac systolic functions during an event of a rupture. The volume of hemopericardium can be used as reference data to determine the mechanism of the rupture. This could also be beneficial in cases of cardiac rupture with similar morphological and pathological features such as severe blunt chest injury and CPR.