II. Epidemiology

  1. Among the most common causes of Sudden Cardiac Death in athletes

III. Pathophysiology

  1. Blunt Chest Trauma at the cardiac cycle time of T-Wave
  2. Results in sudden cardiac depolarization with R on T phenomenon and pulseless arrhythmia
    1. Ventricular Fibrillation (more common with high speed impact)
    2. Asystole

IV. Management: Emergent

  1. ABC Management
  2. Blunt Chest Trauma
  3. Greatest chance of survival is for early cardiac Defibrillation within first 5 minutes
    1. Chance of survival <25% with Defibrillation delayed >5 minutes

V. Management: Following Return of Spontaneous Circulation

  1. Electrocardiogram (EKG)
  2. Echocardiogram
  3. Telemetry (followed by outpatient Holter Monitor or Zio Monitor)

VI. References

  1. Dreis (2020) Crit Dec Emerg Med 34(7):3-21

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Ontology: Commotio Cordis (C2717779)

Definition (MSH) A sudden CARDIAC ARRHYTHMIA (e.g., VENTRICULAR FIBRILLATION) caused by a blunt, non-penetrating impact to the precordial region of chest wall. Commotio cordis often results in sudden death without prompt cardiopulmonary defibrillation.
Concepts Pathologic Function (T046)
MSH D056104
English Concussion, Cardiac, Concussions, Cardiac, Cardiac Concussion, Cardiac Concussions, Commotio Cordis, Commotio Cordis [Disease/Finding]
French Commotio cordis
German Herzerschütterung
Italian Contusione cardiaca, Commotio cordis
Portuguese Commotio Cordis, Concussão Cardíaca
Spanish Commotio Cordis, Conmoción Cardiaca
Russian КОММОЦИЯ СЕРДЦА, SERDTSA SOTRIASENIE, COMMOTIO CORDIS, KOMMOTSIIA SERDTSA, СЕРДЦА СОТРЯСЕНИЕ
Czech komoce srdce, commotio cordis
Swedish Commotio cordis
Polish Wstrząśnienie serca
Japanese 心臓振盪, 心臓震盪, 心臓振とう, 心臓震とう
Norwegian Commotio cordis, Hjerterystelse