Clinical profile of commotio cordis: An under appreciated cause of sudden death in the young during sports and other activities

Barry J. Maron, Mark S. Link, Paul J. Wang, N. A. Mark Estes

Research output: Contribution to journalReview article

71 Citations (Scopus)

Abstract

Not particularly well recognized are athletic field catastrophes in which virtually instantaneous cardiac arrest is produced by nonpenetrating chest blows in the absence of heart disease or identifiable morphologic injury to the chest wall or heart (commotio cordis). To better characterize the clinical profile of this syndrome, we have assembled 70 cases, including 34 occurring during organized competitive athletics and 36 others that occurred during informal recreational sports at home, school or the playground, or during nonsporting activities. Ages were 2 to 38 (mean age: 12) with 70% < 16 years old. Most common sports involved were youth baseball (n = 40), softball (n = 7), and ice hockey (n = 7). Seven (10%) of the 70 commotio cordis victims, including six with documented ventricular fibrillation, have survived the consequences of their chest blow. Eleven of the events (16%) occurred despite the presence of chest padding believed to be potentially protective. Four victims experienced modest chest blows while in circumstances completely unrelated to sports activities; three of the four individuals who delivered these blows were ultimately convicted of criminal acts within the justice system. An experimental model of low-energy chest wall impact demonstrates that commotio cordis events are due largely to the exquisite timing of blows during a narrow window within the repolarization phase of the cardiac cycle, 15 to 30 msec prior to the peak of the T wave.

Original languageEnglish (US)
Pages (from-to)114-120
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume10
Issue number1
StatePublished - Jan 26 1999

Fingerprint

Commotio Cordis
Sudden Death
Sports
Cause of Death
Thorax
Baseball
Thoracic Wall
Hockey
Social Justice
Ventricular Fibrillation
Heart Arrest
Heart Diseases
Theoretical Models
Wounds and Injuries

Keywords

  • Commotio cordis
  • Sports
  • Trauma
  • Ventricular dysrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Clinical profile of commotio cordis : An under appreciated cause of sudden death in the young during sports and other activities. / Maron, Barry J.; Link, Mark S.; Wang, Paul J.; Mark Estes, N. A.

In: Journal of Cardiovascular Electrophysiology, Vol. 10, No. 1, 26.01.1999, p. 114-120.

Research output: Contribution to journalReview article

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