Postmortem Studies Contributions in Understanding Blunt Cardiac Injury with Anatomical Cardiac Damage: A Narrative Review

MethodsThis is a time-and language-limited narrative review of the literature.It includes forensic articles focused on patients with BACI.The steps outlined by the Scale for the Assessment of Narrative Review Articles (SANRA) were followed to provide a strong-quality paper. 6 IntroductIonBlunt cardiac injuries (BCI) are not rare after severe blunt chest trauma, estimated to be present in around 18% of patients arriving at emergency departments (EDs).Many of those are from asymptomatic patients with minimal electrocardiogram (ECG) changes [Organ Injury Scale (OIS) grade I]. 1,2 An estimated incidence of <1% of the patients from all BCI and 8% of the trauma deaths in BCI patients present anatomical damage to the heart and/or pericardium. 1 Blunt anatomical cardiac injury (BACI) corresponds to the anatomical disruption of the heart and/or pericardium and represents the most severe BCI presentation, with exceedingly high mortality. 2-5Amongst the BACI, there is a broad spectrum of injuries from external wall ruptures to the damage inside the heart, including rupture of papillary muscle, valve tears, or coronary involvement.These patients require close follow-up from surgical teams (trauma and/or cardiac), and many need interventions (surgical or percutaneous). [3][4]][5] There is a paucity of publications on BACI, partially due to the low number of patients arriving alive at the hospital.Therefore, important information may be extracted from deceased patients sustaining this entity.This review aims to report the characteristics of the patients deceased with BACI [autopsy BACI (autopBACI)], attempting to provide practical information for physicians working in emergencies and trauma departments.