Cardiac laceration without any external chest injury in an otherwise healthy myocardium - a case series.

The heart is relatively well protected within the thoracic cavity from all the sides. Thus it is rather uncommon to find a cardiac laceration in cases of blunt trauma to the chest and that too when there is no evident injury to the chest wall. Several cases with history of death following blunt trauma were autopsied by us in recent months. Out of them, 3 cases that did not exhibit any external chest injury revealed hemopericardium following rupture of a cardiac chamber. The volume and suddenness of appearance of the hemopericardium were sufficient to cause tamponade. These case reports underline the importance of a systematic and complete autopsy in all cases of blunt trauma deaths even though they may be having no external injury. They also highlight that myocardial injury must be ruled out in every living patient presenting with blunt chest trauma even in the absence of an external sign.