Commotio Cordis || EMS Cardiology

Commotio Cordis is a rare phenomenon where a sudden hit or blow to the chest, typically over the heart 🫀, precipitates sudden cardiac death☠️. Commotio Cordis very appropriately translates to the “agitation of the heart” as it does not necessarily indicate an injury to the heart, but rather a disturbance in the normal cardiac rhythm.

This anomaly can happen to anyone regardless age, gender, profession or current health status. The chances are typically higher in athletes due to the increased potential of impact to the chest (by balls, pucks, elbows, fists, etc.), but the increased heart rate that comes along with sports is believed to be a factor as well. Commotio Cordis can be seen in athletes of baseball ⚾️ , softball 🥎, hockey🏒 , tennis 🎾 , martial arts 🥋 👊🏼 , lacrosse🥍 , etc.

The force behind this impact surprisingly does not have to be severe, in fact, it can be categorized as mild. The blow to the chest does, however, have to occur at just the right moment for this fatal disruption of the cardiac rhythm to occur. This moment is believed to be as ventricular repolarization (relaxation) begins. On a strip, this would be during the upslope of the T wave. This sends the patient from what life-sustaining rhythm they currently have into ventricular fibrillation. 

The immediate initiation of CPR and rapid defibrillation is crucial for these patients to have a chance of survival. Over the years, survival rates have increased and this could possibly be attributed to more awareness and/or AED, being available in most stadiums, gyms and arenas.

Prompt response time, recognition of the condition and rapid treatment from EMS providers or bystanders could save the patient’s life. 🚑

#commotiocordis #emscardiology #emseducation #lightssirensactionems #lightssirensaction