Hemopericardium-related fatalities: a 10-year medicolegal autopsy experience.

BACKGROUND

Patients with blunt or penetrating cardiac injury usually present with cardiac tamponade and hemorrhagic shock upon hospital arrival. Many victims die before they reach hospital. In this study, we present a detailed analysis of hemopericardium-related fatalities.

METHODS

We retrospectively reviewed the medicolegal autopsy records of hemopericardium-related fatalities that occurred from 1994 to 2003. The parameters investigated were demographic characteristics, hospitalization before death, the cause of death, the manner of death, the mechanism of death, the location of the entrance wound, the number of wounds reaching the target and the site of target perforation.

RESULTS

Seven women (mean age: 45 +/- 23 years) and 33 men (mean age: 34 +/- 12 years) were included in the study. Only 5 patients (12.5%) with cardiac activity reached the hospital. Twenty individuals (50%) were victims of stabbings, which was the most common cause of death. The most commonly encountered manner of death was homicide (79%). Thirty-one (77.5%) victims died of hemorrhagic shock and 9 (22.5%) of cardiac tamponade. Entrance wounds were frequently located on the left chest (n = 26). The perforated cardiac chambers were the left atrium (n = 1), the left ventricle (n = 12), the right atrium (n = 2) and the right ventricle (n = 15). One victim had coronary artery perforation. Nine victims had perforations on the intrapericardial part of the aorta.

CONCLUSIONS

In our series, the hemopericardium-related deaths occurred predominantly in men. Stabbing was the most common cause of death. Entrance wounds were most commonly located on the left chest, and perforated sites were ventricles. Death at the scene was also frequent, and the mechanism of death was hemorrhagic shock.