Sudden death due to the atrioventricular node contusion: Three cases report
Wenhe Li1, Lin Zhang, Yue Liang
1Department 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.
Insights
Atrioventricular node (AVN) contusion from blunt chest impact is a rare, fatal condition. Autopsies revealed posterior AVN hemorrhages as the cause of death, emphasizing the need for awareness in forensic pathology.
Area of Science:
- Forensic Pathology
- Cardiovascular Pathology
Background:
- Atrioventricular node (AVN) contusion is a rare, fatal condition causing cardiogenic shock and arrhythmia.
- Diagnosis is challenging due to rapid development and asymptomatic presentation.
Observation:
- Three cases of death following blunt chest impact are presented.
- Autopsies revealed external bruising, sternal/rib fractures, and posterior atrioventricular junction hemorrhages.
Findings:
- Histological examination confirmed cardiac contusion on the posterior atrioventricular junction surface.
- Death was definitively attributed to Atrioventricular node contusion.
Implications:
- Highlights the critical role of autopsy and histological examination in determining cause of death.
- Forensic pathologists must be aware of posterior atrioventricular junction injuries in blunt chest trauma cases.
Introduction:
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.
Clinical Findings:
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.
Conclusion:
The report is intended to raise our understanding and make forensic pathologists aware of the surface of the posterior atrioventricular junction.
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