What are the main symptoms caused by commotio cordis and which are the most commonly used treatments?
Commotio cordis is an often lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (the precordial region), at a critical time during the cycle of a heart beat causing cardiac arrest.
It is a form of ventricular fibrillation (V-Fib), not mechanical damage to the heart muscle or surrounding organs, and not the result of heart disease. The fatality rate is about 65% even with prompt CPR and defibrillation, and more than 80% without
Commotio cordis is a very rare event, but nonetheless is often considered when an athlete presents with sudden cardiac death. Some of the sports which have a risk for this cause of trauma are baseball, American football, association football, ice hockey, polo, rugby football, cricket, softball, pelota, fencing, lacrosse, boxing, karate, kung fu, and other martial arts. Children are especially vulnerable, possibly[citation needed] due to the mechanical properties of their thoracic skeleton
In most reported cases of commotio cordis, sudden death follows a seemingly inconsequential, nonpenetrating blow to the chest. Individuals who have witnessed the events universally believed that the chest trauma was of insufficient force to cause major injury and was out of proportion to the outcome. The person who is struck collapses immediately in most instances. In some instances, the individual has a transient period of consciousness, during which a brief purposeful activity, movement, or behavior (eg, picking up and throwing a ball, crying) is performed before final collapse.
The treatment of commotio cordis is not different from any other cardiopulmonary emergency associated with a nonperfusing cardiac rhythm. For victims of witnessed ventricular fibrillation arrest, as occurs in commotio cordis, early cardiopulmonary resuscitation (CPR) and rapid defibrillation can significantly increase the chances of survival.
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