Podcast 843: Commotio Cordis

Contributor: Jared Scott, MD

Educational Pearls:

• Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest
• A national registry, US Commotio Cordis Registry, reports an average of 10-20 cases annually
• 95% of reported cases occur in males, indicating possible genetic component
• Average age of patient in registry is 15
• Most cases occur during sporting events (baseball in particular), in addition to physical altercations and industrial accidents
• Treatment is high quality CPR and early defibrillation
• Survival rate is improving but remains around 35%
• In recent events, American football player Damar Hamlin survived a Commotio cordis event after being tackled on field and receiving CPR

References

Link MS. Commotio cordis: ventricular fibrillation triggered by chest impact-induced abnormalities in repolarization. Circ Arrhythm Electrophysiol. 2012;5(2):425-432. doi:10.1161/CIRCEP.111.962712

Maron BJ, Poliac LC, Kaplan JA, Mueller FO. Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities. N Engl J Med. 1995;333(6):337-342. doi:10.1056/NEJM199508103330602

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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