commotio cordis (quick review)

5 Feb

QUICK HITS:

Latin origin: “agitation of the heart”

combo of ventricular fibrillation and sudden cardiac death secondary to chest wall impact

 

young people most commonly (mean age 15)

95% male

75% during sports

most cases in sports with blunt projectiles (baseball/lacrosse/hockey) and more physical contact (football, etc.)

 

Only impacts occurring during a 20 to 40 ms window on the upslope of the T-wave (early ventricular repolarization) will cause VF

 

Only impacts occurring directly over the cardiac silhouette result in VF

 

Smaller spherical objects are more likely to induce ventricular arrhythmias than larger spheres and non-spherical objects.   almost never caused by pneumatic objects such as soccer balls and tennis balls.

 

reported survival of only 25% (may be better nowadays with more AEDs/quick defib)

 

Surprising, commercially available chest wall protectors have not been shown to effectively prevent commotio cordis

 

References: uptodate.com; picture

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