Sudden death due to the atrioventricular node contusion

Abstract

Introduction:Atrioventricular node (AVN) contusion usually results in cardiogenic shock and arrhythmia and is a rare but fatal condition. The condition is difficult to diagnose and easily overlooked because it develops rapidly and is asymptomatic. We here report 3 cases that demonstrate blunt chest impact and hemorrhages of the posterior atrioventricular junction, eventually result in death.Clinical Findings:Autopsy and histological examination were performed on all cases. External inspection revealed bruises in the hearts and fractures in the sternum and ribs. However, histological examinations were conclusive and showed cardiac contusion on the surface of the posterior atrioventricular junction of the individuals, and the death was due to the AVN contusion. The position of the AVN on the heart surface is determined by detailed examinations via an autopsy and microscopic, both of which are critical in the certification of cause of death.Conclusion:The report is intended to raise our understanding and make forensic pathologists aware of the surface of the posterior atrioventricular junction.

Cardiac rupture caused by traffic accident: Case reports and a literature review

“…Heart lacerations may involve the right and left atria, the right and left ventricles, the atrial septum, the interventricular septum 6 as well as the intrapericardial portion of the superior or inferior vena cava, the pulmonary veins, the atrioventricular valves and their chordae tendineae or contusion of the conduction system. 13,14 The incidence of cardiac injury after blunt chest trauma in PM studies is reported at between 14% and 25%. 15,16 Autopsy studies show that the right ventricle is most frequently ruptured, followed by the left ventricle, right atrium, intraventricular septum, left atrium and interatrial septum in decreasing frequency.…”

“…Heart lacerations may involve the right and left atria, the right and left ventricles, the atrial septum, the interventricular septum 6 as well as the intrapericardial portion of the superior or inferior vena cava, the pulmonary veins, the atrioventricular valves and their chordae tendineae or contusion of the conduction system. 13,14…”

Story of an Unfortunate Fall: Cardiac Contusion Presenting with an Atrioventricular Block

“…Damage to the atrioventricular node (AVN) can cause different degrees of atrioventricular block. Complete heart block (CHB) is a known complication of BCI and has been reported occasionally in the medical literature [1][2][3][4][5]. The exact mechanism remains poorly understood, especially in the setting of CHB occurring weeks after a fall, in an otherwise structurally and electrophysiologically normal heart.…”