Anatomic Pathology: Forensic Pathology

• The pathophysiology of commotio cordis has been experimentally produced using wooden balls striking the chest of baby pigs. It was found that if the impact occurred at a very specific, narrow part of the cardiac cycle (15 msec before the peak of the T wave), ventricular fibrillation resulted. These findings explain why not every chest impact is fatal. The impact must occur at a very narrow part of the cardiac cycle for the fatal arrhythmia to occur.

Link M, Wang P, Pandian N, et al: An experimental model of sudden death due to low-energy chest-wall impact (commotio cordis). N Engl J Med 1998;338(25):1805-1811.

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