title: Complete cardiac rupture associated with closed chest cardiac massage: case report and review of the literature.
abstract: Chest skeletal injuries are the most frequent complications of external chest massage (ECM) during cardiopulmonary resuscitation, but heart and great vessels lacerations that are indeed very rare. We report the case of a 35-year-old workman who collapsed and underwent ECM by his co-workers for almost 30 min. At autopsy, no external injuries, fractures or bruises of the ribs or sternum, were observed. A hemopericardium with a rupture of the heart was found, with no signs of pre-existent cardiac disease. Bruises of thoracic aortic wall, lung petechiae, a contusion of the liver, and bruises of lumbar muscles were found. The cause of death was due to sudden cardiac death with an extensive cardiac rupture. This is an unusual report of massive heart damage without any skeletal or muscle chest injuries, secondary to cardiopulmonary resuscitation. This kind of cardiac lesions may be considered when thoracic–abdominal trauma, or medical history, is unclear.
authors.forename: Lucia
authors.initials: L
authors.lastname: Tattoli
authors.forename: Eloisa
authors.initials: E
authors.lastname: Maselli
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Romanelli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Di Vella
authors.forename: Biagio
authors.initials: B
authors.lastname: Solarino
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects; D003288:Contusions / Q000473:pathology; D016757:Death, Sudden, Cardiac; D006336:Heart Massage / Q000009:adverse effects*; D006341:Heart Rupture / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000293:injuries / Q000473:pathology; D055370:Lung Injury / Q000473:pathology; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries / Q000473:pathology; D010490:Pericardial Effusion / Q000473:pathology; D035441:Thoracic Wall / Q000293:injuries / Q000473:pathology