Heart-Stopping Hits: What is Commotio Cordis?

August 27th, 2018

You probably haven't heard the name, but you may have seen the headlines: A young, healthy athlete takes a blow to the chest that causes a deadly heart rhythm and sudden death. The condition is known as commotio cordis, Latin for "agitation to the heart."

Fortunately, it's not terribly common. "It is pretty rare, but when it does occur it is really devastating," said Jessica A. Wertz, DO, a primary care physician at Inova Sports Medicine, the official hospital network and sports medicine partner of the Washington Nationals.

Knowing the signs and being prepared can help save lives.

What is Commotio cordis?

Commotio cordis (CC) occurs when a blunt object strikes the chest at just the wrong time in the heart's rhythm. The blow can cause a deadly heart rhythm, often within moments of impact, that can result in death within minutes. Victims typically collapse and show no signs of breathing or a pulse. Sometimes, they can have seizure-like movements, Wertz said.

About 60 percent of CC events occur while playing sports. It is most often reported in baseball, but can also occur in sports such as hockey, lacrosse, soccer and martial arts, when a ball, puck or even an elbow strikes a person's chest.

Young athletes seem to be especially vulnerable, Wertz said. "They tend to be more at risk than older players, because their chest walls are still developing."

CC events are truly freak events. The condition occurs at random, which makes it nearly impossible to predict or prevent. "There's nothing we know of that can put you at risk," Wertz said. "From what we know, this happens in otherwise healthy children."

Fast Action Saves Lives

Though it's difficult to prevent CC, it is possible to keep it from being deadly. If you witness the event, take action:

• Call 9-1-1 immediately.

• Start giving cardiopulmonary resuscitation (CPR).

• If there is an automated external defibrillator (AED) available, use it to try to restart the victim's heart. An AED is a portable device that delivers a shock to the heart.

• Don't hesitate. "If it happens, you have to act quickly," Wertz said.

When CC occurs, time is of the essence. That's why it's so important to recognize the signs, Wertz said. Coaches, athletes and parents should be trained and certified in CPR. Teams should also make sure there's an AED nearby, and that people are familiar with how to use it.

Being Prepared

Several companies advertise chest protectors for athletes designed to prevent CC. Unfortunately, there's not much evidence that they can help, Wertz said. "There is ongoing research to develop chest protectors to reduce risk. But as of now, there aren't any commercially produced protectors that have been shown to be effective."

One thing that can help: Softer balls. Young athletes should use softballs instead of hard baseballs, especially under age 13, Wertz said. "When you're younger, choose a ball that's more forgiving."

Ultimately, the best way to stay safe is to be prepared. "No one thinks it will happen, and you hope it won't, but you have to be prepared for the worst," Wertz said.

The team of experts at Inova Sports Medicine treats patients of all ages and ability levels. To schedule an appointment with Dr. Wertz, call 703-970-6464.