- Sudden cardiac arrest resulting from blunt chest trauma in absence of underlying cardiac disease
- 50% of cases due to competitive sports
- Baseball is most common culprit
- Autopsy usually shows normal cardiac anatomy with no evidence of damage to heart or other intrathoracic structures
- A spectrum of disease due to blunt trauma to the chest wall
- Ranges from cardiac contusion to infarction to cardiac rupture and death.
- Primary electrical event resulting in induction of Ventricular Fibrillation
- Likely due to blow occurring 10-30ms before peak of T wave, although this theory is disputed
- Strike directly over cardiac silhouette ↑ risk of developing commotio cordis
- Younger patients more at risk - compliant chest wall allows transmission of more energy to the heart.
- Standard adult or pediatric cardiac arrest management
- Prognosis is poor, with only 16% survival rate
- Admit to ICU if ROSC is achieved
- See Post Cardiac Arrest
- Yousef R, Carr JA. Blunt cardiac trauma: a review of the current knowledge and management. Ann Thorac Surg. 2014 Sep;98(3):1134-40. doi: 10.1016/j.athoracsur.2014.04.043.
- Ngai KY, Chan HY, Ng F. A patient with commotio cordis successfully resuscitated by bystander cardiopulmonary resuscitation and automated external defibrillator. Hong Kong Med J. 2010 Oct;16(5):403-5.
- El-Menyar A, Al Thani H, Zarour A, Latifi R. Understanding traumatic blunt cardiac injury. Ann Card Anaesth. 2012 Oct-Dec;15(4):287-95. doi: 10.4103/0971-9784.101875.