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What is commotio cordis, the heart condition Damar Hamlin may have suffered?

After Damar Hamlin collapsed during the Bills vs. Bengals game, some medical experts have indicated he may have suffered commotio cordis.

¿Qué es la ‘Commotio Cordis’, la afección cardiaca que relacionan con Damar Hamlin?
DYLAN BUELLAFP

The NFL universe is praying for the health of Buffalo Bills safety Damar Hamlin, who collapsed on field during the first quarter of last night’s Monday Night Football game against the Cincinnati Bengals.

After making a tackle against Cincinnati wide receiver Tee Higgins, Hamlin got to his feet before then collapsing, causing the game to be immediately halted. A defibrillator was used on Hamlin to restart his heart and he was taken to hospital in a critical condition.

Medical opinion on Hamlin collapse

In the aftermath of the shocking scenes, some medical experts have indicated that one possibility to explain what happened to Hamlin is a heart condition known as commotio cordis. This can occur when an individual receives a sharp blow to the chest.

What is commotio cordis?

Concussion or agitation of the heart (commotio cordis) (CC) is an abrupt alteration of the heart rhythm, caused by a non-penetrating impact on the chest region that is transmitted to the cardiac muscle. The condition is most commonly seen in younger individuals (8 to 18 years old) during sports practice.

When the trauma occurs at a certain point in the cardiac pumping cycle, it triggers irregular heart rhythms (arrhythmias) which can lead to the heart stopping altogether.

The term commotio cordis was first used in the 19th century, although heart concussion had been described earlier. In accounts of the ancient Chinese martial art of Dim Mak (or death touch), where blows to the the left part of the sternum caused the sudden death of the opponent. The absence of structural cardiac injury distinguishes concussion from cardiac contusion (bruising or trauma), in which high-impact blows produce traumatic injury to myocardial tissue and thorax.

According to the database of the National Commotio Cordis Registry in Minneapolis, it is among the most frequent cardiovascular causes of sudden death among young people who practice sports, after hypertrophic cardiomyopathy and congenital anomalies of the coronary artery.

Treatment of commotio cordis

Prompt treatment with an automated external defibrillator and CPR are indicated where a subject suffers commotio cordis. CPR and defibrillation must be started as soon as possible (within three minutes) for maximal benefit.