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Q and A: Can a Blow to the Chest Kill an Adult Male?

02 May

Q: In my WIP I was planning to have someone killed by a strong blow to the chest. I know death has occurred this way in children, specifically young baseball players who get hit in the chest by a ball or bat. Could such a blow kill a grown man?

Nora Barker, Author of Murder in Primary Colors

 
A: This is an extremely rare occurrence but can happen in either children or adults. A blow to the chest can cause a cardiac death in several ways.

The trauma could be of sufficient force to directly damage the heart muscle, causing it to rupture, resulting in sudden death. Or, a heart valve could be damaged so severely that the heart could no longer function efficiently as a pump and the victim could die from the resulting shock. Here death could take many minutes or hours. The blow could bruise the heart muscle (called a cardiac contusion) and this could cause a deadly cardiac arrhythmia, again with sudden death.

Also, the trauma, even without an overt cardiac contusion, could cause electrical instability and a deadly arrhythmia–usually either ventricular tachycardia (VT) or ventricular fibrillation (VF).

Another possibility is that the force of the chest trauma could cause the heart to be propelled backward where it could bounce against the spinal column. The atrioventricular node (AV node or AVN) is found on the back side of the heart. It is the relay station that carries the heart’s electrical pulses from the upper chambers to the lower chambers. If the AVN is bruised or damaged, complete heart block, where no electrical impulses travel through the AVN, could result. If so the heart rate might drop to 25-30 per minute and this could lead to sudden collapse and death.

So yes a blow to the chest can kill by any of these mechanisms but each is exceedingly rare and very unpredictable. This unpredictability makes it a poor choice for murder as killers like things to be more certain—like gunshots and stabs and poisons. Still, it’s possible.

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2 Comments

Posted by on May 2, 2012 in Medical Issues, Q&A, Trauma

 

2 responses to “Q and A: Can a Blow to the Chest Kill an Adult Male?

  1. jackieedwards

    May 3, 2012 at 7:25 am

    Thanks so much, Dr. Lyle. I’m envisioning a situation where someone swings a champagne bottle in anger, on an impulse, with no thought out intention to kill. Sounds like that would work.
    Nora Barker

     
  2. tacgirl2000

    December 13, 2012 at 2:38 am

    Another possibility although I know you are talking specifically about a localized high impulse blow to the chest or sternum. I spent years training in karate in the late 60s and 70s with Tak Kubota where the training and often how I was treated would not be tolerated nowadays. A few stories here. In Japan when he was young he got into a fight with another master. In those days, it was believed that one could use the strengthened ends of the fingers to slam into the solar plexus then grab the bottom of the sternum to rip the rib cage. I think it was an urban-karate-legend of the day. Kubota would show me how his Xiphoid process was permanently injured and he would dig under his chest and flip the darn thing out so you could see the triangular shape tent up the skin. In those days (he came in peak shape to the US in 1963) he could without to much preparation hammer through six baked bricks and unlike the demonstrators of the 70s, there was no spacing between the bricks. If he trained for six months, he would do demonstrations where he would hammer down on a hundred pound ice cube and pulverize it. Again, unlike most demonstrations it was not layers of ice slabs separated by pencils. He was hired to do a commercial for 7-Up where the camera would shoot him pulverizing the ice cube (simply amazing) then pan downward to show the pile of ice surrounding a Seven-Up bottle. He was so excited that he not only went through the ice cube, he hit the top of the bottle shattering it and causing some serious damage to his hand. In those years, another master Mas Oyama, an immensely strong person who was built like a tree had a challenge a prize fighter in a ring. Oyama hit him with three powerful straight punches to the center of the sternum and the fighter went down unconscious. I always wondered what his medical outcome was. A number of competitors died from fighting when struck in the lower right part of the ribcage which would break and lacerate the liver. They’d walk away then bleed to death. In the late 70s or 80s I was sparring with an ex-International class fighter from Kubota’s school who had a fiendish trick which I fell for. He would fake a front kick which would cause you to try and block it, then seeing it was a feint, you’d pause, then he’d re-kick without letting his knee down. He hit me square under the right part of the rib cage and I went down and couldn’t move for perhaps 20 minutes and was one of the most painful injuries I had ever received. A disadvantage of being an advanced student is that you’re always trying to shake off potentially serious injuries. About three weeks later I had a doctor’s appointment for a physical. When my doctor palpated my liver I probably yelped or screamed and nearly teleported off the examination table to which my doctor said, “Oh I didn’t know that you are a big drinker.” My liver was still quite swollen and I’m certain that I was very lucky and probably had some minor tears in the liver. My apologies for going slightly off topic but I thought you might like hearing some of these things I had seen and experienced.

     

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