Commotio cordis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2]

Overview

Commotio cordis should be distinguished from cardiac contusion, which occurs when a blunt strike to the chest damages the structural heart structures. the differential diagnosis of commotio cordis includes other causes of sudden cardiac death during sport participation, such as familial hypertrophic cardiomyopathy, myocarditis, dilated cardiomyopathy, long-QT syndrome, Brugada syndrome, Wolf-Parkinson-White syndrome, Marfan syndrome, aortic valve stenosis, mitral valve prolapse, coronary artery disease, asthma, heat stroke, drug abuse, and a ruptured cerebral artery. It is important to consider the possibility of intentional acts of violence causing commotio cordis.

Differential diagnosis

Commotio cordis should be distinguished from a condition called a cardiac contusion, which occurs when a blunt strike to the chest damages the structural heart structures. Motor vehicle accidents are an example of such a case. The differential diagnosis of commotio cordis includes other causes of sudden cardiac death during sport participation, such as[1][2]:

In addition to accidental causes, commotio cordis can also be caused by intentional acts of violence. There have been reported cases of homicidal commotio cordis caused by domestic violence[3].

References

  1. Longmuir PE, Brothers JA, de Ferranti SD, Hayman LL, Van Hare GF, Matherne GP, Davis CK, Joy EA, McCrindle BW (May 2013). "Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American Heart Association". Circulation. 127 (21): 2147–59. doi:10.1161/CIR.0b013e318293688f. PMID 23630128.
  2. Palacio LE, Link MS (March 2009). "Commotio cordis". Sports Health. 1 (2): 174–9. doi:10.1177/1941738108330972. PMC 3445066. PMID 23015869.
  3. Mu J, Zhang J, Liu L, Dong H (April 2016). "Homicidal commotio cordis caused by domestic violence: A report of two cases". Med Sci Law. 56 (2): 138–41. doi:10.1177/0025802415575590. PMID 25757838.

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