Commotio cordis is an episode of ventricular fibrillation (VF) induced by a sudden blunt trauma to the chest. A direct blow to the chest from a baseball, hockey puck, or a collision with another player or a stationary object typically causes this condition. For VF to occur, the blow must
happen at a precise millisecond of the heart’s electrical cycle. This phenomenon has been observed in humans and is well documented in laboratory animals.
When the blow to the chest occurs at this precise moment in the heart’s cycle, the heart will “fibrillate.” The blow usually causes no identifiable structural injury to the ribs, sternum, or the heart itself.
At the time of the blow to the chest, Louis was a healthy young man who was wearing an approved chest protector. Current chest-protective technology does not seem to prevent this event from happening. Furthermore, it is unlikely that chest protectors can ever completely prevent this condition because many sports positions are incompatible with the use of chest protectors (e.g., baseball infielder or pitcher).
Recent data from the registry of the Minneapolis Heart Institute Foundation shows that commotio cordis is one of the leading causes of sudden cardiac death in young athletes, exceeded only by hypertrophic cardiomyopathy and congenital coronary artery abnormalities.
Some cases of commotio cordis may be prevented by the use of better sports equipment, such as chest protectors, and softer balls.
With faster recognition and prompt action, a large percentage of commotio cordis cases are potentially reversible. These actions can help save the life of a person suffering an episode of commotio cordis:
- Recognition of commotio cordis and appropriate actions are taken immediately
- Early application of CPR and defibrillation
- Fast response time
- Availability of AEDs at all athletic locations
- All coaches, umpires, trainers, and parents should be trained in CPR and AED skills
- Have emergency action plans in place
- Teach athletes how to protect themselves against chest injuries. Coaches and parents should work with kids on proper playing and position techniques through controlled practice sessions.
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