Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
103667 | Legal Medicine | 2015 | 4 Pages |
•We reviewed postmortem CT scans and autopsies for fatal cases of acute type A aortic dissection with hemopericardium.•We found a pericardial tear at the left posterolateral site of the pericardium and a left hemothorax.•The pericardial tear was a consequence of CPR and intrapericardial blood leaked through the pericardial tear resulting in a hemothorax.•A stress concentration was exerted on the left pericardial–diaphragmatic junction during CPR, resulting in a pericardial rupture.
We present two cases of a pericardial tear as a consequence of cardiopulmonary resuscitation involving chest compressions in fatal acute type A aortic dissection (AoD) with hemopericardium. For each case, postmortem computed tomography revealed a hematoma in the false lumen of the ascending aorta with a slight hemopericardium and a large left hemothorax, as well as focal pericardial dimpling and discontinuity around the left ventricle. At autopsy, we confirmed a convex lens-shape gaping pericardial tear at the left posterolateral site of the pericardium and a massive volume of bloody fluid in the left thoracic cavity. It has been hypothesized that the pericardium ruptured due to chest compressions during resuscitation in these cases of acute type A AoD with hemopericardium and that intrapericardial blood leakage through the pericardial tear resulted in a hemothorax.