Fatal Isolated Right Ventricular Rupture Without External Chest Injury in a Young Driver: Forensic Autopsy Findings...

Area of Science:

• Forensic Pathology
• Trauma Medicine
• Cardiovascular Surgery

Background:

• Blunt cardiac injury (BCI) is a rare but serious condition, often leading to high mortality rates.
• Traffic accidents are a primary cause of BCI, resulting from severe impacts that compress the heart.
• Blunt cardiac rupture (BCR) is particularly lethal, frequently causing rapid death.

Purpose of the Study:

• To report a case of blunt cardiac rupture (BCR) with an unusual presentation.
• To emphasize the significance of internal examination in trauma fatalities, even without external signs of injury.

Main Methods:

• Case report of a 19-year-old male involved in a high-energy vehicle collision.
• Crime scene investigation noting significant vehicle damage but minimal external chest trauma.
• Autopsy examination revealing a right ventricle rupture and pericardial tamponade.
• Toxicology analysis detecting pregabalin, but not at lethal levels.

Main Results:

• Autopsy confirmed a 2-cm rupture of the right ventricle.
• 400 cc of blood were found in the pericardial cavity, indicating cardiac tamponade.
• Absence of significant external chest trauma was noted despite severe internal cardiac injury.

Conclusions:

• The case demonstrates that blunt cardiac rupture can occur without external chest trauma.
• Thorough internal examination during autopsy is crucial for diagnosing severe internal injuries in trauma-related deaths.
• This case underscores the potential for fatal internal injuries in high-energy impacts, necessitating comprehensive forensic investigation.