Iatrogenic cardiac herniation: post mortem case

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine
• Trauma Surgery

Background:

• Pericardial incisions are utilized in cardiothoracic surgery and trauma management.
• Chest trauma, including gunshot wounds, can lead to complex injuries affecting the heart and surrounding structures.
• Cardiac herniation is a rare but potentially fatal complication following cardiac procedures or trauma.

Observation:

• A case of sudden cardiac death is presented following a gunshot wound to the chest.
• Autopsy revealed the heart had herniated through a pericardial incision.
• The pericardial incision appeared elongated, suggesting a mechanism for herniation.

Findings:

• The herniation of the heart led to acute compression of the coronary arteries.
• Coronary artery constriction resulted in acute myocardial infarction.
• This sequence of events was identified as the cause of sudden cardiac death.

Implications:

• Highlights a rare but critical complication of pericardial incisions in the context of penetrating chest trauma.
• Underscores the importance of meticulous surgical technique and post-operative monitoring in trauma cases.
• Provides insight into the patho-mechanisms of sudden cardiac death following chest injuries and surgical interventions.