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Korean Journal of Legal Medicine 1994;18(1):7-11.
Traumatic Myocardial Infarction ? Review of an Autopsy Case in an Aspects of Medicolegal Conflict ?
Jong Tae Park
Department of Forensic Medicine, Chonnam National University Medical School
Abstract
Myocardial infarction induced by nonpenetrating blunt trauma on the chest is un- common and has rarely been reported. Clinically, the chest pain caused by traumatic myocardial infarction could often be masked or interpreted erroncous ly because the variety of symptoms could developed in such cases, and sometimes interpreted as trauma -induced bone or muscle pain and neglected. When, however, the infarction is developed, it frequently takes a course of sudden death even thought clinicians take intensive care of the other major injuries, and the events become to medicolegal conflict. The review of such cases may keep the clinicians on the alert of the possibility of myocardial infarction and sudden death. I have experience of an autopsy case of myocardial infarction after blunt trauma on the chest. Clinicians diagnosed this case as post-traumatic myocardial infarction with serum level of aspartate aminotransferase, lactic acid dehydrogenase, and creatine pliospliokinase and electrocardiographic findings of premature ventricular contraction and bizzare QRS complex, but patient died of sudden onset of shocl?. In autopsy and his histological examination, aorta and coronary system were relatively intact. Discontinuity of endocardium and myocardial muscle fibers was noted at the wall of left ventricle and interventricular septum. The cut surface of left ventricular wall showed necrotic focus with whitish discoloration, and the hole of perforation. The patient died of cardiac tamponade.
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