[Morphology and vital reaction in heart injuries]

In injuries of the heart after action of blunt and sharp force as well as gunshot injuries, in particular the histological findings are also important with regard to survival time and capacity of action. Single observations have given rise to the impression that vital reactions occur here earlier (thrombocyte aggregates, leukocytic emigration, formation of clots) than is the case in other organs. Systematic investigations of 48 cases amongst 373 heart injuries (3.9% of 11,342 autopsies, from 1983 to the last quarter of 1988) from the Institute for Forensic Medicine of the University of Munich as well as occasional cases from the Institute of Forensic Medicine of the Free University of Berlin did not show any leukocytic reactions in light microscopy with no or short survival time. In electron microscopic terms, leukocytic reactions, thrombocyte aggregates or deposits of fibrin were not to be discerned even in heart injuries which were survived for a short time. However, high-grad contractions and condensations of the muscle fibers with filamentous evaginations into which the mitochondria were pressed were shown characteristically. These alterations indicated a vital process, but they may possibly also occur even in the earliest supravital phase. In a total of 25 cases with confirmed survival time between 30 minutes and five days, cell reactions were shown which largely corresponded to the familiar time course. A prematurely occurring reaction was not to be observed.(ABSTRACT TRUNCATED AT 250 WORDS)