Rapidly Recognize Commotio Cordis
Those watching last night’s marquis NFL matchup between the Cincinnati Bengals and Buffalo Bills witnessed what is most likely Commotio Cordis (CC). CC, Latin for ‘agitation-commotion of the heart', occurs when the chest wall receives an impact that results in the development of a ventricular fibrillation (a lethal arrhythmia). CC can occur in any sport, irrespective of whether the individual is wearing chest protection. CC occurs far more commonly in young, thin men, and classically occurs with impact of relatively low intensity.
The immediate actions required are:
1. Identification that the player is pulseless
2. Immediate institution of CPR with initiation of 911 Emergency Response
3. Defibrillation as soon as possible
The good news is this is a freak and rare event occurring only when a perfect amount of energy is applied to the chest wall of a susceptible person at the perfect time in the cardiac electrical cycle. The bad news is that this is fatal unless the above immediate actions are instituted.
We are all hoping for the best outcome for Damar Hamlin. The positive here is that due to the visibility of this event, there will be a new societal awareness of CC.
Incidentally, having spent 20 years of my life coaching my kid’s baseball, football, and ice hockey teams, I always ensured that I had an AED in my car at practices and games in the event I witnessed CC. Since most people are not Electrophysiologists and will not own an AED, ALWAYS KNOW where the AED is located at your sporting venues.
Physician, Scientist, Medical Educator, and Entrepreneur (LightLab Imaging) with more than 25 years at Harvard and MIT.
2 年I am unsure how anyone can be confident this was Commotio Cordis which is literally less common than being hit by a lightening strike. The hospital clearly isn’t confident as he is still on a monitor and oxygen. 1. It is usually from much more energy, like a fast ball to the chest. 2. The impact was light by nfl standards and he had chest, so the last sudden death in the nfl was I believe 1971. 3. The video after impact he got up , pushed another player, turned then showed signs. Even for a professional athlete if he was in VT he would not have looked that good. 3. Far more common disorders that include channelopathies and HCM could occur after exertion or a light impact. Part of the problem is why are they only giving partial information. They fly him with a medical teal from a university hospital to a small Buffalo hospital to be discharged in 48 hrs. That is odd. Why did he have ARDS? I can’t envision giving him the diagnosis of cc and letting him play again.
Acute Account Executive, Mid-Atlantic
2 年Thank you for sharing Manish.
Owner of Rydahl LLC.
2 年Well said Manish! Dr Rogers does a free screening every year for high school athletes. It is worth taking your kids in to get checked. He finds all sorts of defects. Long Qt etc..
Consultant
2 年Thanks for posting this, clearly valuable information
Healthcare Consultant specializing in Wearables and Algorithms and Access to Care
2 年Great insights. Thanks for sharing