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Homicidal cardiac lacerations in children
S D Cohle1, D A Hawley, K K Berg
1Blodgett Memorial Medical Center, Grand Rapids, MI, USA.
Journal of Forensic Sciences
|March 1, 1995
Summary
Intentionally inflicted cardiac lacerations are rare in young children, often accompanied by rib fractures. Such severe chest trauma in this age group is almost always non-accidental.
Area of Science:
- Forensic Pathology
- Pediatric Trauma
- Cardiovascular Surgery
Background:
- Cardiac lacerations are severe injuries to the heart.
- Blunt force trauma is a common cause of cardiac rupture.
- Accidental cardiac lacerations typically result from high-impact events like motor vehicle accidents.
Observation:
- This study details six cases of intentionally inflicted cardiac laceration in victims aged 9 weeks to 2.5 years.
- Five victims were female, and the right atrium was the most common site of laceration (5/6 cases).
- Associated injuries included rib fractures in four patients, with multiple fractures per patient.
Findings:
- Confessed cases involved direct physical assault (fist, stomping, kicking).
- Cardiac rupture mechanisms include blunt force, abdominal compression, deceleration, and rib puncture.
- No documented cases link cardiopulmonary resuscitation to cardiac laceration or rib fractures in children.
Implications:
- Highlights the non-accidental nature of severe chest trauma in pediatric cases presenting with cardiac laceration and rib fractures.
- Emphasizes the need for forensic investigation in suspected child abuse cases involving severe blunt force trauma.
- Underscores the rarity of cardiac and rib injuries from pediatric CPR, differentiating them from inflicted trauma.