Commotio Cordis

Commotio cordis – a rare event that can cause sudden cardiac arrest by disrupting the normal heart rhythm, usually occurs due to a low-impact blow to the chest. This can precipitate during sports activities such as football, hockey, baseball, and cricket, and typically affects young athletes under 20 years of age; the condition is rare in those over 25. 

The underlying causes of commotio cordis can include structural and electrical abnormalities in the heart, such as coronary artery anomalies, hypertrophic heart, cardiomyopathies, and conduction disturbances like Long QT Syndrome, Short QT Syndrome, or Catecholaminergic polymorphic ventricular tachycardia. The symptoms include – unresponsiveness, apnea, pulselessness, and no audible heartbeat. 

Immediate medical attention is mandatory; the treatment typically involves cardiopulmonary resuscitation (CPR) and defibrillation using a defibrillator machine or automated external defibrillator (AED). The sooner defibrillation is performed, the higher the chances of survival. 

To prevent commotio cordis, young athletes should wear protective equipment like chest shields while playing sports that poses risk of collision. 

This condition should not be confused with contusio cordis, which is also caused by blunt trauma to the chest, and can lead to heart muscle contusion, cardiac chamber rupture, or heart valve disruption. Contusio cordis often occurs in cases of motor vehicle accidents.

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