The role of the autopsy in the diagnosis of commotio cordis lethal cases: Review of the literature.

Commotio Cordis (CC) diagnosis is based on the occurrence of a blunt, non-penetrating blow to the chest preceding cardiovascular collapse and the absence of structural damage that would explain any observed effects. In CC lethal cases, the execution of the autopsy represents a possible diagnostic tool. Nevertheless, to date in the literature no author expresses an opinion about the use of the autopsy. In the light of the above, the authors propose a review of the literature about this topic. The review consents to state that the occurrence of a blunt blow to the chest is a necessary element for a lethal CC diagnosis, but it cannot be considered enough. Indeed, because CC is a recognized cause of sudden cardiac death, the autopsy should be always performed to exclude the presence of structural damage that would explain any observed effects. This approach is fundamental in order to achieve an accurate diagnosis and to distinguish CC from other causes of sudden cardiac death. In addition, the authors sustain that in case of autopsy data's lack the authors should not identify CC diagnosis as definitive but as possible.