Commotio cordis (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Overview

Commotio cordis is condition where the the patient experiences cardiac arrest secondary to blunt trauma to his chest and most often leads to sudden death. This condition is generally seen in healthy young athletes as a result of a non-penetrating blow to the chest. Sports such as baseball, soccer, ice hockey, polo, rugby, cricket, softball, pelota, fencing, lacrosse, boxing, karate, kung fu and other martial arts are associated with this condition. Many factors contribute towards commotio cordis and does not solely depend upon the force of the blow. Only about a quarter of these victims survive even after immediate resuscitation. Children are more vulnerable because of the pliability of their chest walls.

Who is at the highest risk?

Young athletes who are involved in sports such as baseball, soccer, ice hockey, polo, rugby, cricket, softball, pelota, fencing, lacrosse, boxing, karate, kung fu and other martial arts where there is a likelihood of sustaining blow to the chest.

When to seek urgent medical care?

9-1-1 should be contacted immediately when the athlete is found to be unresponsive, apneic, pulseless, and without an audible heartbeat. Emergent resuscitation is mandated by any person who is trained in CPR and AED (automated external defibrillator).

Where to find medical care for commotio cordis

Directions to Hospitals Treating Commotio Cordis

What to expect (Outlook/Prognosis)?

Commotio codris has a poor prognosis with only about a quarter of these victims surviving after immediate resuscitation.

Prevention of commotio cordis

Unfortunately, the commercially available chest wall protectors have not shown to be effective in prevention of commotio cordis. Many of the victims reported to the national commotio cordis registry were indeed wearing protective equipment at the time of their event.

• Athletes should be trained to turn away from oncoming projectiles whenever possible to avoid blow directly to the chest.

• Softer and less dense balls should be used whenever possible

• Protective chest gears should be used whenever possible

Possible complications

• Death