Commotio cordis electrocardiogram: Difference between revisions
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{{CMG}}; {{AE}} {{MHP}} | {{CMG}}; {{AE}} {{MHP}} | ||
==Overview== | ==Overview== | ||
The most common [[rhythm]] observed in [[commotio cordis]] cases is [[ventricular fibrillation]] (VF). Other [[arrhythmias]] such as [[polymorphic ventricular tachycardia]], [[complete heart block]], idioventricular rhythm, [[atrial fibrillation]], [[ST-segment elevation]], [[T-wave abnormalities]] were reported. The timing and location of the impact are crucial in the generation of VF in commotio cordis. When the impact occurs directly over the heart within a specific window during the upslope of the [[T wave]] in [[ventricular repolarization]], it triggers a rapid increase in [[left ventricular intracavitary pressure]], leading to VF. | |||
==Electrocardiogram== | ==Electrocardiogram== | ||
* Electrocardiogram (ECG) findings in commotio cordis can vary depending on the timing of the ECG recording and the presence of arrhythmias. | * [[Electrocardiogram]] ([[ECG]]) findings in [[commotio cordis]] can vary depending on the timing of the ECG recording and the presence of [[arrhythmias]]. | ||
* The most common rhythm observed in commotio cordis cases is ventricular fibrillation (VF). Other arrhythmias were reported, such as: | * The most common [[rhythm]] observed in commotio cordis cases is [[ventricular fibrillation]] (VF). Other [[arrhythmias]] were reported, such as: | ||
** Polymorphic ventricular tachycardia | ** [[Polymorphic ventricular tachycardia]] | ||
** Complete heart block | ** [[Complete heart block]] | ||
** Idioventricular rhythm | ** [[Idioventricular rhythm]] | ||
** Atrial fibrillation | ** [[Atrial fibrillation]] | ||
** ST-segment elevation | ** [[ST-segment elevation]] | ||
** T-wave abnormalities | ** [[T-wave abnormalities]] | ||
* It is important to note that ECG findings may not always be abnormal in commotio cordis cases. reported a case of commotio cordis where the patient did not show any arrhythmias and did not receive any resuscitation procedure. The ECG alterations observed in this case improved over time<ref name="pmid23234817">{{cite journal |vauthors=Maringhini G, Fasullo S, Vitrano G, Terrazzino G, Ganci F, Paterna S, Di Pasqual P |title=Commotio cordis without arrhythmic event and resuscitation: ECG, echocardiographic, angiographic and cardiovascular resonance imaging study |journal=BMJ Case Rep |volume=2012 |issue= |pages= |date=December 2012 |pmid=23234817 |pmc=4543299 |doi=10.1136/bcr-03-2011-3968 |url=}}</ref><ref name="pmid35658897">{{cite journal |vauthors=Patel N, Pena C, Nesheiwat Z, Zafrullah F, Eltahawy E |title=Ventricular fibrillation arrest after blunt chest trauma in a 33-year-old man, commotio cordis? |journal=BMC Cardiovasc Disord |volume=22 |issue=1 |pages=252 |date=June 2022 |pmid=35658897 |pmc=9166514 |doi=10.1186/s12872-022-02689-4 |url=}}</ref><ref name="pmid25489014">{{cite journal |vauthors=Ota K, Bratincsak A |title=Atrial fibrillation induced by commotio cordis secondary to a blunt chest trauma in a teenage boy |journal=Pediatrics |volume=135 |issue=1 |pages=e199–201 |date=January 2015 |pmid=25489014 |doi=10.1542/peds.2014-1972 |url=}}</ref>. | * The timing and location of the impact are crucial in the generation of VF in [[commotio cordis]]. When the impact occurs directly over the heart within a specific window during the upslope of the [[T wave]] in [[ventricular repolarization]], it triggers a rapid increase in [[left ventricular]] intracavitary pressure, leading to VF. | ||
[[image:CCLEKGPig.jpg|thumb| | * It is important to note that [[ECG]] findings may not always be abnormal in [[commotio cordis]] cases. reported a case of commotio cordis where the patient did not show any [[arrhythmias]] and did not receive any [[resuscitation]] procedure. The [[ECG]] alterations observed in this case improved over time<ref name="pmid23234817">{{cite journal |vauthors=Maringhini G, Fasullo S, Vitrano G, Terrazzino G, Ganci F, Paterna S, Di Pasqual P |title=Commotio cordis without arrhythmic event and resuscitation: ECG, echocardiographic, angiographic and cardiovascular resonance imaging study |journal=BMJ Case Rep |volume=2012 |issue= |pages= |date=December 2012 |pmid=23234817 |pmc=4543299 |doi=10.1136/bcr-03-2011-3968 |url=}}</ref><ref name="pmid35658897">{{cite journal |vauthors=Patel N, Pena C, Nesheiwat Z, Zafrullah F, Eltahawy E |title=Ventricular fibrillation arrest after blunt chest trauma in a 33-year-old man, commotio cordis? |journal=BMC Cardiovasc Disord |volume=22 |issue=1 |pages=252 |date=June 2022 |pmid=35658897 |pmc=9166514 |doi=10.1186/s12872-022-02689-4 |url=}}</ref><ref name="pmid25489014">{{cite journal |vauthors=Ota K, Bratincsak A |title=Atrial fibrillation induced by commotio cordis secondary to a blunt chest trauma in a teenage boy |journal=Pediatrics |volume=135 |issue=1 |pages=e199–201 |date=January 2015 |pmid=25489014 |doi=10.1542/peds.2014-1972 |url=}}</ref>. | ||
[[image:CCLEKGPig.jpg|thumb|1000px|center|Six lead electrocardiogram and intraventricular pressure measurement from an 11 kg swine undergoing a 48 km/h (30 mph) chest wall impact with an object the shape and weight of a standard baseball<ref name="pmid17957272">{{cite journal |vauthors=Madias C, Maron BJ, Alsheikh-Ali AA, Estes Iii NA, Link MS |title=Commotio cordis |journal=Indian Pacing Electrophysiol J |volume=7 |issue=4 |pages=235–45 |date=October 2007 |pmid=17957272 |pmc=2018736 |doi= |url=}}</ref>]] | |||
[[Image:Commotio-cordis-ecg.jpg|center|thumb|300px|Electrocardiogram schematic tracing, showing the period of vulnerability to stretch-induced ventricular fibrillation which occurs in commotio cordis.]] | [[Image:Commotio-cordis-ecg.jpg|center|thumb|300px|Electrocardiogram schematic tracing, showing the period of vulnerability to stretch-induced ventricular fibrillation which occurs in commotio cordis.]] | ||
Latest revision as of 07:22, 29 August 2023
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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
The most common rhythm observed in commotio cordis cases is ventricular fibrillation (VF). Other arrhythmias such as polymorphic ventricular tachycardia, complete heart block, idioventricular rhythm, atrial fibrillation, ST-segment elevation, T-wave abnormalities were reported. The timing and location of the impact are crucial in the generation of VF in commotio cordis. When the impact occurs directly over the heart within a specific window during the upslope of the T wave in ventricular repolarization, it triggers a rapid increase in left ventricular intracavitary pressure, leading to VF.
Electrocardiogram
- Electrocardiogram (ECG) findings in commotio cordis can vary depending on the timing of the ECG recording and the presence of arrhythmias.
- The most common rhythm observed in commotio cordis cases is ventricular fibrillation (VF). Other arrhythmias were reported, such as:
- The timing and location of the impact are crucial in the generation of VF in commotio cordis. When the impact occurs directly over the heart within a specific window during the upslope of the T wave in ventricular repolarization, it triggers a rapid increase in left ventricular intracavitary pressure, leading to VF.
- It is important to note that ECG findings may not always be abnormal in commotio cordis cases. reported a case of commotio cordis where the patient did not show any arrhythmias and did not receive any resuscitation procedure. The ECG alterations observed in this case improved over time[1][2][3].
References
- ↑ Maringhini G, Fasullo S, Vitrano G, Terrazzino G, Ganci F, Paterna S, Di Pasqual P (December 2012). "Commotio cordis without arrhythmic event and resuscitation: ECG, echocardiographic, angiographic and cardiovascular resonance imaging study". BMJ Case Rep. 2012. doi:10.1136/bcr-03-2011-3968. PMC 4543299. PMID 23234817.
- ↑ Patel N, Pena C, Nesheiwat Z, Zafrullah F, Eltahawy E (June 2022). "Ventricular fibrillation arrest after blunt chest trauma in a 33-year-old man, commotio cordis?". BMC Cardiovasc Disord. 22 (1): 252. doi:10.1186/s12872-022-02689-4. PMC 9166514 Check
|pmc=value (help). PMID 35658897 Check|pmid=value (help). - ↑ Ota K, Bratincsak A (January 2015). "Atrial fibrillation induced by commotio cordis secondary to a blunt chest trauma in a teenage boy". Pediatrics. 135 (1): e199–201. doi:10.1542/peds.2014-1972. PMID 25489014.
- ↑ Madias C, Maron BJ, Alsheikh-Ali AA, Estes Iii NA, Link MS (October 2007). "Commotio cordis". Indian Pacing Electrophysiol J. 7 (4): 235–45. PMC 2018736. PMID 17957272.