Death of a 23-year-old man from cardiac conduction system injury through a blunt chest impact after a car accident.

Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increasedfrequency over the past decades. Traffic accidents are the most frequent causes of cardiac contusionresulting from a direct blow to the chest. Myocardial contusion is difficult to diagnose; the clinicalpresentation varies greatly, ranging from a lack of symptoms to cardiogenic shock and arrhythmia.Although death is rare, cardiac contusion can be fatal.The Authors report a case of death due to a cardiac conduction system injury from a blunt chest impactfollowing a car accident. The autopsy showed no external signs of thoracic trauma, no evident rib orsternum fractures. A small subendocardial hemorrhage was found in the region of the atrioventricularnode. Histological examination revealed an injury of the atrioventricular node and His' bundle. Thecause of the death was attributed to the arrhythmia induced by contusion of the cardiac conductionsystem.