The traumatic extracorporeal ejection of a beating heart has not been witnessed and reported in the literature previously, to our knowledge. Here we present two cases of vehicle accidents leading to this fatal injury, both in a rabbit and a human.
Case 1. One late evening in June, in the land of the midnight sun, a young man was driving to his favourite fishing river for a spot of trout fishing in a remote part of Eastern Finland. While driving his aged Nissan Almera at 60 km/h down a dusty gravel road on this dusky night, suddenly a young male rabbit jumped onto the road and appeared in the beam of his headlights. Despite the man’s evasive manoeuvres, the rabbit was struck by the left front corner of the car. After hitting the brakes and the car eventually coming to a standstill, the young man went to inspect the animal he had hit….
In conclusion, we present that in a very rare constellation of forceful blunt trauma to the chest, the heart can be completely avulsed and ejected from the body in human as in animals. Larger prospective and randomised studies are probably not needed to confirm these findings. Just be careful – it is possible to lose your heart to a car.
2. Stahl RD, Liu JC, Walsh JF. Blunt cardiac trauma: atrioventricular valve disruption and ventricular septal defect. Ann Thorac Surg 1997;64:1466-8.
3. Trotter TH, Knott-Craig CJ, Ward KE. Blunt injury rupture of tricuspid valve and right coronary artery. Ann Thorac Surg 1998;66:1814-6.
4. Singh H, Ali S, Luni FK, Hashmi F, Taleb M. Isolated rupture of bicuspid aortic valve following blunt chest trauma: a case report and systematic review of literature. Cardiovasc Diagn Ther 2017;7:89-91.
5. Esmaeilzadeh M, Alimi H, Maleki M, Hosseini S. Aortic valve injury following blunt chest trauma. Res Cardiovasc Med 2014;3:e17319.
6. Devineni R, McKenzie FN. Avulsion of a normal aortic valve cusp due to blunt chest injury. J Trauma 1984;24:910-2.
7. Yang S, Wang C, Chen H. Partial aortic annulus avulsion and formation of aortic-left ventricle tunnel through interventricular septum after blunt cardiac trauma. Eur J Cardiothorac Surg 2011;40:255-6.
8. Gorman R, Nuttall SM. Traumatic right ventricular rupture following a horse kick. BMJ Case Rep. Nov 2012 ed: BMJ Publishing Group Ltd.; 2012:1-2.
9. Brathwaite CE, Rodriguez A, Turney SZ, Dunham CM, Cowley R. Blunt traumatic cardiac rupture. A 5-year experience. Ann Surg 1990;212:701-4.
10. Fulda G, Brathwaite CE, Rodriguez A, Turney SZ, Dunham CM, Cowley RA. Blunt traumatic rupture of the heart and pericardium: a ten-year experience (1979-1989). J Trauma 1991;31:167-72; discussion 72-3.
11. Chaumoitre K, Zappa M, Portier F, Panuel M. Rupture of the right atrium-superior vena cava junction from blunt thoracic trauma: helical CT diagnosis. AJR Am J Roentgenol 1997;169:1753.
12. Degiannis E, Brink J, Haagensen M, Williams P, Boffard K. Rupture of the auricle of the right atrium of the heart and pericardium after blunt trauma. Eur J Surg 2001;167:472-4.
13. Doll D, Glapa M, Bonanno F, Smith MD, Dusel W, Degiannis E. [Traumatic rupture of the cardiac auricle after forceful blunt abdominal trauma]. Unfallchirurg 2007;110:637-9.
14. Aghayev E, Jackowski C, Thali MJ, Yen K, Dirnhofer R, Sonnenschein M. Heart luxation and myocardium rupture in postmortem multislice computed tomography and magnetic resonance imaging. Am J Forensic Med Pathol 2008;29:86-8.
15. Aho AJ, Vanttinen EA, Nelimarkka OI. Rupture of the pericardium with luxation of the heart after blunt trauma. J Trauma 1987;27:560-3.
16. Assing M, Dragicevic N, Hazelton TR, Nallamshetty L. Delayed levorotation of the heart in traumatic pericardial rupture. Emerg Radiol 2011;18:257-61.
17. Turk EE, Tsokos M. Blunt cardiac trauma caused by fatal falls from height: an autopsy-based assessment of the injury pattern. J Trauma 2004;57:301-4.
18. de Campos Fonseca Pinto A, Massad M, Ribas L, et al. Complete cardiac and bronchial avulsion in a dog: Post-mortem computed tomography and forensic necropsy analysis. Journal of Forensic Radiology and Imaging 2017;8:45-7.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.