ISSN: 0022-1198
CODEN: JFSCA
Page Count: 7

Homicidal Cardiac Lacerations in Children
Hawley, DA
Associate Professor of Pathology, Indiana University School of Medicine, IN

Kiesel, EL
Chief Medical Examiner, Snohomish County Medical Examiner Office, WA

Pless, JE
Clyde G. Culbertson Professor of Pathology, Indiana University of Medicine, IN

Berg, KK
Assistant Chief Medical Examiner, Hennepin County, MI

Cohle, SD
Blodgett Memorial Medical Center, MI

(Received 23 May 1994; accepted 21 July 1994)

Abstract

We report six cases of intentionally inflicted cardiac laceration. The victims ranged in age from 9 weeks to 2 ½ years. Five victims were girls and in five cases the right atrium was lacerated. The left ventricle was lacerated in the other case. In the three cases with a confession, one victim each was struck with a fist, stomped, and kicked. Four patients had rib fractures, with at least two fractures in each case. Cardiac rupture from blunt trauma most commonly results from compression of the heart between the sternum and vertebral column, but may also occur from compression of the abdomen or legs, deceleration, blast injury, puncture of the heart by a fractured rib, and rupture through a resolving contusion. Accidentally acquired cardiac lacerations usually result from motor vehicle accidents or similarly severe forces. In children there are neither well documented cases of cardiac laceration nor of rib fractures from cardiopulmonary resuscitation. Cardiac lacerations, as with other types of severe trauma acquired at home, are almost never accidental.

Keywords:
pathology and biology, heart injuries, child abuse, homicide, wounds, nonpenetrating

Paper ID: JFS15344J
DOI: 10.1520/JFS15344J
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