What is Commotio Cordis?

Commotio cordis is a very rare but tragic event that can occur in young athletes. Commotio cordis is caused by a blow to the chest (directly over the left ventricle) that occurs during a certain part of a person's heart beat.1 The blunt force trauma can send the heart into a fatal arrhythmia called ventricular fibrillation.1 It is a cardiac concussion phenomenon which occurs in in the absence of heart disease or injury to the structures surrounding the heart.2

 Guthrie, K. (2010, May 17). Sudden Cardiac Death due to 

Commotio Cordis. Retrieved November 8, 2015.  

Research has shown that location of impact, timing of impact and force of impact all play  a role in commotio cordis.2 The timing of the impact was found to be the most important variable.2 Impacts occurring before the T wave of an ECG was shown to be the most lethal impact.2 The lethal arrhythmia occurred most when the impact hit at the center of the left chest wall.2 Lastly the force and velocity of the impact is critical in commotio cordis.2 Impacts of up to 25-30 mph can induce ventricular fibrillation.2 This is why baseball has the highest occurrence of commotio cordis because baseballs are dense and can travel up to velocities of 30 to 50 mph.2

In 1995, 188 athletes died from commotio cordis.1 Of those 188 deaths, 96% were males athletes.1 In 1996 the United States Commotio Cordis Registry was initiated.2 Of the cases reported there were two main terrifying realizations, 1) majority of the cases occurred in young athletes with a mean age of 15 and 2) there seem to be a higher prevalence of males.2 Most incidences occur in sports such as baseball, lacrosse, hockey and softball.2   

Survival rates of commotio cordis are reported by the United States Commotio Cordis Registry of 35% compared to 15% that was reported in the 1990’s decade.2 Although the survival chances have increased, it is still exceptionally low.2 The high percentage of fatalities exist because of the failure to initiate timely treatment.2 The American Heart Association recommends immediate CPR and AED action to increase survival.2

References:

1NATA Official Statement on Commotion Cordis. (2007, October 1). Retrieved November 1, 2015.

2Cano-Keighley, M. (2012, July 1). Commotion Cordis. Retrieved November 1, 2015.