And Understanding The Risks to Young Athletes

Commotio cordis is a phenomenon in which a sudden impact to the chest causes an abnormal heart rhythm, often leading to cardiac arrest. This condition is most commonly seen in young athletes and is the leading explanation for sudden cardiac death in athletes under the age of 25.

Commotio cordis occurs when a sudden impact to the chest causes a disruption of the electrical activity in the heart, known as ventricular fibrillation. This can happen as a result of a direct blow to the chest, such as from a baseball or a hockey puck, or from an indirect blow, such as a fall onto a hard surface. The impact causes a temporary malfunction in the electrical conduction system of the heart.

The exact mechanism of commotio cordis is not fully understood, but it is believed to be caused by a specific timing of the impact in relation to the heart's electrical cycle. The impact must occur during a specific phase of the heart's electrical cycle known as the vulnerable period, which is when the heart is in a state of relative electrical refractoriness. If the impact occurs during this vulnerable period, it can trigger an abnormal heart rhythm and lead to cardiac arrest.

Commotio cordis is a rare condition, but it is a leading cause of sudden cardiac death in young athletes. It is estimated that there are approximately 3 to 12 cases of commotio cordis per year in the United States, with the majority of cases occurring in athletes under the age of 25.

The signs and symptoms of commotio cordis can be similar to those of a heart attack,

including chest pain, shortness of breath, and fainting. However, the onset of symptoms is sudden and can occur immediately following an impact to the chest.

Prevention of commotio cordis is crucial. The most effective prevention strategy is to wear chest protectors during sports activities. Some sports organizations have required them for the players. Also using proper technique and avoiding contact to the chest during the sports activity can help minimize the risk of commotio cordis.

Commotio cordis is a rare but serious condition that can occur as a result of a sudden impact to the chest. It is a leading explanation for sudden cardiac death in young athletes. Through awareness, proper safety measures, and understanding the risks, we can work to prevent this condition and ensure the safety and well-being of our young athletes.