Emergency Medical Minute9 Jan 2023

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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