HOMICIDAL CARDIAC LACERATIONS IN CHILDREN

We report six cases of intentionally inflicted cardiac laceration. The victims ranged in age from 9 weeks to 2 1/2 years. Five victims were girls and in five cases the right atrium was lacerated. The left ventr icle was lacerated in the other case. In the three cases with a confes sion, one victim each was struck with a fist, stomped, and kicked. Fou r patients had rib fractures, with at least two fractures in each case . Cardiac rupture from blunt trauma most commonly results from compres sion of the heart between the sternum and vertebral column, but may al so occur from compression of the abdomen or legs, deceleration, blast injury, puncture of the heart by a fractured rib, and rupture through a resolving contusion. Accidentally acquired cardiac lacerations usual ly result from motor vehicle accidents or similarly severe forces. In children there are neither well documented cases of cardiac laceration nor of rib fractures from cardiopulmonary resuscitation. Cardiac lace rations, as with other types of severe trauma acquired at home, are al most never accidental.