The NFL’s latest performance on Monday Night Football revealed a rare but deadly affliction found in sports: commotio cordis. According to a study by New England Journal of MedicineThe exact rates of commotio cordis are not known, but it is one of the most common cardiovascular causes of sudden death in young athletes.
Commotio cordis, Latin for “excitement of the heart,” is an injury that occurs when blunt trauma to the chest disrupts the heart’s rhythm, sending those who experience it into cardiac arrest.
Commotio Cordis in Sport
As long as it is unconfirmed that Damar Hamlin experienced commotio cordis on the field Monday night, known to have gone into sudden cardiac arrest after taking a hit. If commotio cordis was the culprit, it wouldn’t be the first time a player in a professional sporting event suffered from it.
In 1998, a hockey player Chris Pronger went into cardiac arrest after a puck hit him in the chest. He survived the accident and recent news suggests that Hamlin is also on the road to recovery.
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Commotio cordis is often associated with baseball because it occurs when a ball hits a player in the chest, but almost all majors sports have seen cases of trauma. It most commonly affects younger male athletes between the ages of eight and 18.
For commotio cordis to occur, the moment of impact must be precise, which it does an extremely rare event. As the heart pumps blood throughout the body, it emits electrical signals. Being hit by an object sends additional electrical waves through the body. If these electrical waves hit the heart at the wrong time, they can disrupt the heart’s rhythm, triggering commotio cordis and sending a person into cardiac arrest.
Commotio cordis is distinguished from other cardiovascular disorders because it leaves no structural damage to the heart. By definition, it can only occur in the absence of underlying cardiovascular disease. Various factors can affect the chances of survival, including the object’s shape, hardness, diameter, and impact speed. Also, the variability of a person’s chest, such as the thinness of their chest wall, can change the chances of survival.
Reduction of future Commotio Cordis events
There are several specific conditions that lead to the highest risk of commotio cordis if an object strikes at the wrong time, according to a study published in Journal of Biomechanical Engineering.
The study, conducted by a team of researchers at Western University, simulated 128 baseball impacts to a person’s chest at 16 different impact locations and four different levels of baseball stiffness. The results show that an initial velocity of 17.88 meters per second and an impact location above the heart left chamber caused the greatest damage.
“My research examines how we can prevent commotio cordis in children who play sports,” said lead researcher Grant J. Dickey, c research supplement. “Current baseball chest protectors fail to prevent commotio cordis, with deaths occurring frequently in children wearing chest protectors.”
The study also showed that the force of hitting a baseball did not correlate with the strain on the left ventricle, which is the heart’s main blood-pumping chamber. Rather, deformations of the ribs above the left ventricle correlate strongly with the pressure and strain on the heart chamber.
“We have now identified vulnerable positions above the chest that can lead to commotio cordis in children playing baseball,” Dickey says in the addendum. “Our future research aims to explore other sports and ways in which we can prevent commotio cordis and save the lives of children in sports.”