Commotio cordis: sudden death due to chest wall impact

ABSTRACT

Commotio Cordis is the sudden onset of ventricular fibrillation caused by blunt trauma to the heart. Although rare, it is an important cause of sudden death in young athletes.

This article focuses on the investigation of factors associated with an increased risk of Commotio Cordis following anterior chest wall impact. The recording of the triggering factors of this fatal arrhythmia could help in the creation of prevention protocols.

Inclusion criteria in this article were the studies that had been published in the English language. The following terms “Commotio Cordis pathophysiology”, “Commotio Cordis epidemiology”, “chest impact”, and “ventricular fibrillation” were searched individually and in combinations. Exclusion criteria were language other than English and type of article (letter to the editor, editorial).

Extrinsic risk factors are the point of impact on the chest, the time of the heart cycle at the time of impact as well as the size of the object. Biological characteristics such as gender, chest wall flexibility, and genetic susceptibility also play a role in Commotio cordis.

The Commotio Cordis phenomenon concerns the scientific community worldwide. Increased efforts are needed to prevent early recognition and treatment of blunt chest trauma during sports to reduce life-threatening arrhythmias associated with high mortality.

Keywords: Commotio cordis, ventricular fibrillation, sudden cardiac death, chest wall impact