Citation

Lupariello F, Curti SM, Di Vella G. Am. J. Forensic Med. Pathol. 2018; 39(4): 330-336.

Affiliation

From the Sezione di Medicina Legale, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, "Università degli Studi di Torino," Torino, Italy.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/PAF.0000000000000433

PMID

30234548

Abstract

The diagnosis of lethal commotio cordis (CC) is really complex. The forensic pathologist's task is even more relevant when he/she has to explain a CC diagnosis caused by an assault in a trial. The purpose of this study was to analyze the literature on lethal CC as a result of violent attacks and identify relevant parameters that may help in the diagnosis. A review of the relevant articles was performed. Fifty-two cases of CC caused by violent attacks were identified. The collected data allowed to confirm the following literature's criteria for CC diagnosis in case of assaults: witnessed occurrence of a blunt, nonpenetrating blow to the chest preceding cardiovascular collapse; absence of structural damage to the sternum, ribs, or heart itself; and absence of any underlying cardiovascular abnormalities (such as other causes of sudden death). Regarding the assessment of the third criterion, the authors suggest that the pathologist should always specify the scientific autopsy guidelines that he/she used to differentiate CC from the other causes of sudden death. In addition, the authors highlight the importance of a multidisciplinary approach for a correct interpretation of clinical, autopsy, and laboratory findings.

Language: en