Commotio Cordis: Prevention and Survival

Abstract

Commotio cordis is a rare yet potentially fatal event. Young athletes are more susceptible to CC due to their pliable, underdeveloped chest wall. It is the second most common cause of death in young athletes. After a projectile strikes an athlete over the precordial area and ventricular fibrillation occurs, the individual has minutes before their chance of mortality is greater than their chance of survival. Survival of CC relies on immediate recognition, and early CPR and defibrillation with an AED. Increased awareness and education of CC, as well as CPR and AED training is imperative. As these survival factors continue to improve, so too will survival rates of CC. Victims of CC who survive do not have any long-term effects from the incident, unless brain or organ damage occurred from delayed resuscitation and defibrillation. Survivors can return to play upon passing a thorough cardiac evaluation to rule out any structural heart disease. All return to play decisions should be considered case by case. Rates of CC reoccurrence are extremely low due to the nature of the event, but it has been reported. Prevention may be enhanced through the use of safety baseballs and effective chest protectors. While the technology used in chest protectors has advanced greatly in the last three years, until a chest protector can be developed that completely eliminates the risk of CC, it can still occur. Proper use of safety equipment is imperative to lowering the incidence rate of CC.