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Unusual presentation of more common disease/injury
Overzealous cardiac massage leading to unintentional infant death
  1. Fatos Sinani1,
  2. Besim Ymaj1,
  3. Gentian Vyshka2
  1. 1Pathology Department, Institute of Forensic Medicine, Tirana, Albania
  2. 2Biomedical and Experimental Department, Faculty of Medicine, Tirana, Albania
  1. Correspondence to Dr Gentian Vyshka, gvyshka{at}


The case of an 18-month child is presented, with a picture demonstrating the thoracic trauma, caused from a hand pressure movement, perpetrated with an open right palm, in an attempt to perform an external cardiac massage. The child showed continuous episodes of ‘crying spells’ that the medical staff considered as benign, but an overprotective and mentally unstable mother kept on violently ‘resuscitating’ her son during such episodes. The last episode was characterised with a strenuous massage of the thoracic wall, causing evident bruises and leading to a cardiac contusion. The mother who perpetrated the trauma was sentenced for manslaughter, after the accidental character of the event, as well as the severity of her family situation and the precarious living environment of a socially abandoned single-acting parent, were all taken into account. The particular psychopathology of the care giver (mother) and the characteristics of the inflicted thoracic blow are described.

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  • Competing interests None.

  • Patient consent Obtained.

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