Iatrogenic cardiac herniation: post mortem case.

A case is presented in which sudden cardiac death was caused by herniation of the heart through a pericardial incision following a gunshot wound to the chest, resulting in acute compression of the coronary arteries. At autopsy the heart protruded through the pericardial incision, which appeared to have elongated, and the cause of death was thought to be acute myocardial infarction secondary to coronary artery constriction.