Emergency medicine & sports medicine physicians often cover sporting events where athletes are at risk of commotio cordis
2nd most common cause of sudden cardiac death in young athletes in the US (HCM #1)
Young males between 4 and 18 years old are at greatest risk
50% of all cases occur during competitive sports (baseball #1)
Nonpenetrating, blunt trauma to the chest resulting to cardiac arrhythmia and, often, sudden cardiac death.
Ventricular fibrillation (VF) is the most common arrhythmia.
Thought to occur secondary to a precordial impact during an electrically vulnerable portion of ventricular repolarization (10-30 msec before the T-wave peak)
Treatment: Immediate chest compressions and early use of an automated external defibrillator (AED) ((effective in only 15% of cases))
Survival is much improved if resuscitation administered within 3 minutes (25%) than after 3 minutes (3%)
Differential diagnosis: other causes of sudden cardiac death including HCM, coronary artery anomalies, long QT syndrome, Brugada syndrome, WPW, CAD, myocarditis, arrhythmogenic right ventricular dysplasia
