“…This injury pattern is most frequently observed in motor vehicle accidents and falls from a height, yet other causes have been described, including direct blows to the chest, sporting and industrial injuries and kicks by animals. 1 Possible mechanisms to account for these injuries include acute deceleration, forcefull anteroposterior compression of the heart against the sternum and vertebral column, lacerations by adjacent rib or sternal fractures and rarely, sudden massive return of venous blood to the heart after blunt abdominal trauma. 3 Anteroposterior compression of the heart is viewed as the most common mechanism accounting for these injuries.…”