Sudden Cardiac Arrest Caused by a Ball Impact to the Chest Wall: Commotio Cordis

Abstract

A sudden cardiac death caused by a blunt forceful trauma in the chest wall region is called commotio cordis. It is considered to be the second leading cause of sudden death in a young athlete after hypertrophic obstructive cardiomyopathy. The number of reported cases is increasing by the year and that corresponds to the increased awareness of the condition. Commotio cordis by definition is blunt trauma to the chest wall in the area of the cardiac silhouette causing a ventricular fibrillation. The actual mechanism of the induction of the ventricular fibrillation is complicated but can be simplified as a forced depolarization in the impact area caused by a disturbance of the K^ATP channel, which, if happened in a specific time in the cardiac cycle specifically within 20 - 10 ms before the T wave peak, will lead to a ventricular fibrillation. Here, we discuss a 25-year-old man that got hit with a tennis ball during a match and was luckily revived with the aid of an automated external defibrillator (AED).




J Med Cases. 2017;8(12):393-395
doi: https://doi.org/10.14740/jmc2941w