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Commotio cordis: What is the rare phenomenon?

Athletes use specific gear to protect themselves
Commotio Cordis: What is the rare phenomenon?
Posted at 5:26 AM, Jan 04, 2023
and last updated 2023-01-04 10:40:09-05

DENVER — Since the nation learned Buffalo Bills safety Damar Hamlin suffered a cardiac arrest, there has been widespread speculation about what exactly caused it. A very rare phenomenon has been discussed, but not confirmed: Commotio cordis.

“Commotio cordis is a very rare cause of sudden cardiac death, primarily in athletes, or anybody who receives blunt force trauma to your chest, right over your heart," said Dr. Bill Cornwell, the director of the Sports Cardiology Clinic at UCHealth. “Somebody drops suddenly because they have a bad rhythm that is not compatible with life. And unless somebody intervenes very quickly, they will likely pass away.”

Dr. Cornwell said that quick intervention should come in the form of CPR or defibrillators, and the sooner it happens, the better.

“Survival is very low, because the body requires immediate resuscitation. Like any cardiac arrest event, the longer that you wait to begin CPR, to begin intervening, to try to restore blood flow to the body — the longer that period of time — the less likely somebody is to survive. The faster somebody intervenes, the higher the likelihood of surviving.”

Athletes use specific gear to protect against rare heart phenomenon

For the most part, the very rare Commotio cordis occurs in sports like hockey or baseball, or even karate.

“Those types of things where we have a solid object moving at a very high velocity that hits the chest right over the heart, at a very specific time point throughout the phase of what we call the cardiac cycle, or the phase of where the heart is squeezing and then beginning to relax again," Dr. Cornwell explained.

Dr. Cornwell said it is less common in sports where the athletes wear chest protection, but can still happen in sports like lacrosse or football.

“For the most part, if one of these objects hits your chest, but you're protected by an inch of gear, that lowers the risk, but it does not completely eliminate it," Dr. Cornwell said.

Commotio cordis has not been directly linked to Hamlin's incident.

"We could hypothesize for 10 minutes on other things that this could have been. And, you know, football especially, like I said — when the chest is protected, your risk of Commotio cordis is not eliminated, but it's also not the most common thing," he said.

At the first day of preseason practice for East High School lacrosse, Head Coach Alex Creech said he specifically structures his practices where the risk of a shot to the chest with a ball is decreased.

“That's one of my biggest fears that ever happens on the field, where our goalie takes a shot or one of our defenders to the chest and they drop, what's my plan of action? So we do go through training where we do have our CPR certification, do the AED," Creech said.

One of the goalies on the team, Will Moreno, said he is grateful for the new chest protection gear they are mandated to wear, which is thicker.

“It just puts it all into perspective, for sure," Moreno said before practice. "Because they say it's like a textbook type of thing that you read about, but it can happen in real life. So you have to be cautious of it.”