A fatal case of commotio cordis caused by an accidental fall on the beach

Area of Science:

• Forensic Medicine
• Cardiology
• Pathology

Background:

• Sudden cardiac death (SCD) is a significant public health concern and a frequent challenge in forensic medicine.
• Common causes of SCD include congenital heart disease, cardiomyopathy, myocarditis, coronary artery pathology, and channelopathies like long/short QT syndromes and Brugada syndrome.
• Commotio cordis, a form of SCD resulting from blunt chest trauma, is typically associated with young individuals and direct blows during physical activity.

Observation:

• This report details a rare case of an adult female experiencing sudden cardiac death due to commotio cordis.
• The incident occurred following an accidental fall on wet sand while walking on a beach.
• The victim had no significant prior medical history.

Findings:

• Commotio cordis, though rare, can occur in adults and is not limited to young athletes.
• Post-mortem diagnosis is crucial, emphasizing the need for a thorough understanding of the event's circumstances.
• Macroscopic examination of the heart may appear normal, necessitating systematic histological examination for definitive diagnosis.

Implications:

• This case highlights that commotio cordis can affect adults, expanding the demographic typically associated with this condition.
• Forensic investigations into sudden cardiac death must consider accidental trauma as a potential cause, even in non-athletic, adult individuals.
• The findings underscore the importance of detailed case history and meticulous histological analysis in diagnosing commotio cordis, particularly when macroscopic findings are unremarkable.