Commotio cordis natural history, complications and prognosis

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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

Almost all of the patients with commotio cordis will die without any proper intervention due to arrhythmia. More than two third of those with prompt cardiopulmonary resuscitation/defibrillation experience a full physical recovery, while the remaining patients exhibit mild to moderate residual neurological disability or cardiac impairment during the follow-up period spanning from 1 to 20 years.

Natural history, complications and prognosis

Natural history

Almost all of the patients with commotio cordis will die without any proper intervention due to arrhythmia. Prompt cardiopulmonary resuscitation and defibrillation are the main interventions which increase the survival rates.

Complications

• Generally, it is assumed that if commotio cordis is successfully treated and recovered, no further heart complications will develop in most of the cases.
• A study demonstrated that out of the total cases of commotio cordis with particularly prompt cardiopulmonary resuscitation/defibrillation, 71% experienced a full physical recovery, while the remaining 29% exhibited mild to moderate residual neurological disability or cardiac impairment (noted through a decrease in left ventricular ejection fraction) during the follow-up period spanning from 1 to 20 years.

Prognosis

• Commotio cordis has a poor prognosis with only a small number of these victims surviving after immediate resuscitation. A continuous rise of survival rates due to commotio cordis is evident, shifting from 10%–15% before the year 2000 to more than 50% in 2012 l.

• There is a 10 percent decline in survival rate in the first minute following the loss of consciousness. Five percent decline in survival rate in each following minute following the loss of consciousness.