synonyms:SCA, Commotio Cordis / Sudden Cardiac Arrest
Commotio Cordis ICD-9
Commotio Cordis Etiology / Epidemiology / Natural History
- Commotio Cordis = Ventricular arrhymias (generally V. Fib) from sudden, blunt, low-impact force to the chest without apparent heart injury.
- Generally young males involved in ball related sports (baseball).
- Survival rates are low (10%). (Maron BJ, Am J Cardiol. 1997;15:840).
- @ 2-4 deaths per year in baseball (Janda DH, Clin J Sports Med 1992;2:172)..
- Sudden cardiac arrest accounts for @115 deaths/yr in the US.
Commotio Cordis Clinical Evaluation
- Pulseless with no breath sounds after blunt trauma to chest wall.
- Hypertrophic Cardiomyopathy (HCM): accounts for 50% of cases of sudden cardiac death in young athletes. HCM should be considered in any adolescent athlete with a left ventricular wall thickness of 12mm in males (11mm in females) and a nondilated ventricle (<48mm). HCM is an absolute contraindication for vigorous exercise. (Sharma S, J Am College Cardiol 2002;40:1431).
Commotio Cordis Classification / Treatment
- Immediate institution of cardiopulmonary resuscitation and activation of EMS.
- Early defibrillation (AED) for ventricular fibrillation may improve survival. Precordial thump if defibrillation unavailable
Commotio Cordis Complications
Commotio Cordis Follow-up Care
- Emergent transfer to hospital.
Commotio Cordis Review References
- Demorest RA, OKU-Sports Medicine 3
- www.nata.org (search for sudden cardiac arrest)
- Denzer JA, J Athl Train. 2007;42:143
- McCrory P, Br J Sports Med 2002;36:236