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Commotio Cordis

MedGen UID:
439278
•Concept ID:
C2717779
•
Pathologic Function
Synonyms: Cardiac Concussion; Cardiac Concussions; Concussion, Cardiac; Concussions, Cardiac

Definition

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. [from MeSH]

Professional guidelines

PubMed

Emergency department management of pediatric blunt thoracic injuries.
Goodwin G, Bengio M, Ryckeley CB, Marin MN
Pediatr Emerg Med Pract 2023 Nov 15;20(Suppl 11):1-30. PMID: 37877783
Diagnostic Criteria for Commotio Cordis Caused by Violent Attack: Review of the Literature.
Lupariello F, Curti SM, Di Vella G
Am J Forensic Med Pathol 2018 Dec;39(4):330-336. doi: 10.1097/PAF.0000000000000433. PMID: 30234548
Pathophysiology, prevention, and treatment of commotio cordis.
Link MS
Curr Cardiol Rep 2014;16(6):495. doi: 10.1007/s11886-014-0495-2. PMID: 24760424

Recent clinical studies

Etiology

Pediatric Sports-Related Injuries.
Brown T, Moran M
Clin Pediatr (Phila) 2019 Feb;58(2):199-212. Epub 2018 Nov 27 doi: 10.1177/0009922818810879. PMID: 30477308
Pathophysiology, prevention, and treatment of commotio cordis.
Link MS
Curr Cardiol Rep 2014;16(6):495. doi: 10.1007/s11886-014-0495-2. PMID: 24760424
Athletes and arrhythmias.
Link MS, Estes NA
J Cardiovasc Electrophysiol 2010 Oct;21(10):1184-9. doi: 10.1111/j.1540-8167.2010.01808.x. PMID: 20522153
Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO
Circulation 2009 Mar 3;119(8):1085-92. Epub 2009 Feb 16 doi: 10.1161/CIRCULATIONAHA.108.804617. PMID: 19221222
What is commotio cordis?
Link MS, Wang PJ, Maron BJ, Estes NA
Cardiol Rev 1999 Sep-Oct;7(5):265-9. doi: 10.1097/00045415-199909000-00010. PMID: 11208236

Diagnosis

Commotio Cordis in 2023.
Peng T, Derry LT, Yogeswaran V, Goldschlager NF
Sports Med 2023 Aug;53(8):1527-1536. Epub 2023 Jun 29 doi: 10.1007/s40279-023-01873-6. PMID: 37382827Free PMC Article
Sudden Cardiac Death Among Adolescents in the United Kingdom.
Finocchiaro G, Radaelli D, D'Errico S, Papadakis M, Behr ER, Sharma S, Westaby J, Sheppard MN
J Am Coll Cardiol 2023 Mar 21;81(11):1007-1017. doi: 10.1016/j.jacc.2023.01.041. PMID: 36922085
Forensic Pathological Identification and Antidiastole of Commotio Cordis.
Tian MH, Gao WM, Jia YQ, Xue JJ, Xiao Y, Cao ZP, Zhu BL
Fa Yi Xue Za Zhi 2018 Oct;34(5):538-541. Epub 2018 Oct 25 doi: 10.12116/j.issn.1004-5619.2018.05.020. PMID: 30468059
Blunt Cardiac Trauma Review.
Huis In 't Veld MA, Craft CA, Hood RE
Cardiol Clin 2018 Feb;36(1):183-191. doi: 10.1016/j.ccl.2017.08.010. PMID: 29173678
Blunt Cardiac Injury.
Marcolini EG, Keegan J
Emerg Med Clin North Am 2015 Aug;33(3):519-27. Epub 2015 Jun 10 doi: 10.1016/j.emc.2015.04.003. PMID: 26226863

Therapy

Commotio Cordis in Non-Sport-Related Events: A Systematic Review.
Lee RN, Sampaio Rodrigues T, Gan JT, Han HC, Mansour R, Sanders P, Farouque O, Lim HS
JACC Clin Electrophysiol 2023 Aug;9(8 Pt 1):1321-1329. Epub 2023 Mar 22 doi: 10.1016/j.jacep.2023.01.010. PMID: 37558288
Commotio Cordis in 2023.
Peng T, Derry LT, Yogeswaran V, Goldschlager NF
Sports Med 2023 Aug;53(8):1527-1536. Epub 2023 Jun 29 doi: 10.1007/s40279-023-01873-6. PMID: 37382827Free PMC Article
Is Exercise Helpful or Harmful in Dealing With Specific Arrhythmia.
El Masri I, Kayali SM, Blount C, Kirolos I, Khouzam JP, Kabra R
Curr Probl Cardiol 2021 Mar;46(3):100740. Epub 2020 Nov 2 doi: 10.1016/j.cpcardiol.2020.100740. PMID: 33213943
Diagnostic Criteria for Commotio Cordis Caused by Violent Attack: Review of the Literature.
Lupariello F, Curti SM, Di Vella G
Am J Forensic Med Pathol 2018 Dec;39(4):330-336. doi: 10.1097/PAF.0000000000000433. PMID: 30234548
Safety baseballs and chest protectors: a systematic review on the prevention of commotio cordis.
Classie JA, Distel LM, Borchers JR
Phys Sportsmed 2010 Apr;38(1):83-90. doi: 10.3810/psm.2010.04.1765. PMID: 20424405

Prognosis

Blunt Cardiac Trauma Review.
Huis In 't Veld MA, Craft CA, Hood RE
Cardiol Clin 2018 Feb;36(1):183-191. doi: 10.1016/j.ccl.2017.08.010. PMID: 29173678
Athletes and arrhythmias.
Link MS, Estes NA
J Cardiovasc Electrophysiol 2010 Oct;21(10):1184-9. doi: 10.1111/j.1540-8167.2010.01808.x. PMID: 20522153
Commotio cordis.
Maron BJ, Estes NA 3rd
N Engl J Med 2010 Mar 11;362(10):917-27. doi: 10.1056/NEJMra0910111. PMID: 20220186
Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO
Circulation 2009 Mar 3;119(8):1085-92. Epub 2009 Feb 16 doi: 10.1161/CIRCULATIONAHA.108.804617. PMID: 19221222
Commotio cordis.
Zangwill SD, Strasburger JF
Pediatr Clin North Am 2004 Oct;51(5):1347-54. doi: 10.1016/j.pcl.2004.04.001. PMID: 15331287

Clinical prediction guides

The role of the autopsy in the diagnosis of commotio cordis lethal cases: Review of the literature.
Lupariello F, Di Vella G
Leg Med (Tokyo) 2019 May;38:73-76. Epub 2019 Apr 24 doi: 10.1016/j.legalmed.2019.04.007. PMID: 31030120
Blunt Cardiac Injury.
Marcolini EG, Keegan J
Emerg Med Clin North Am 2015 Aug;33(3):519-27. Epub 2015 Jun 10 doi: 10.1016/j.emc.2015.04.003. PMID: 26226863
Blunt cardiac injury.
Bock JS, Benitez RM
Cardiol Clin 2012 Nov;30(4):545-55. Epub 2012 Sep 5 doi: 10.1016/j.ccl.2012.07.001. PMID: 23102031
Commotio cordis.
Zangwill SD, Strasburger JF
Pediatr Clin North Am 2004 Oct;51(5):1347-54. doi: 10.1016/j.pcl.2004.04.001. PMID: 15331287
Catastrophic pediatric sports injuries.
Luckstead EF, Patel DR
Pediatr Clin North Am 2002 Jun;49(3):581-91. doi: 10.1016/s0031-3955(02)00006-8. PMID: 12119866

Recent systematic reviews

Commotio Cordis in Non-Sport-Related Events: A Systematic Review.
Lee RN, Sampaio Rodrigues T, Gan JT, Han HC, Mansour R, Sanders P, Farouque O, Lim HS
JACC Clin Electrophysiol 2023 Aug;9(8 Pt 1):1321-1329. Epub 2023 Mar 22 doi: 10.1016/j.jacep.2023.01.010. PMID: 37558288
Accuracy of diagnostic tests in cardiac injury after blunt chest trauma: a systematic review and meta-analysis.
Kyriazidis IP, Jakob DA, Vargas JAH, Franco OH, Degiannis E, Dorn P, Pouwels S, Patel B, Johnson I, Houdlen CJ, Whiteley GS, Head M, Lala A, Mumtaz H, Soler JA, Mellor K, Rawaf D, Ahmed AR, Ahmad SJS, Exadaktylos A
World J Emerg Surg 2023 May 27;18(1):36. doi: 10.1186/s13017-023-00504-9. PMID: 37245048Free PMC Article
Clinical and electrocardiographic features of complete heart block after blunt cardiac injury: A systematic review of the literature.
Ali H, Furlanello F, Lupo P, Foresti S, De Ambroggi G, Epicoco G, Semprini L, Fundaliotis A, Cappato R
Heart Rhythm 2017 Oct;14(10):1561-1569. Epub 2017 Jun 3 doi: 10.1016/j.hrthm.2017.05.040. PMID: 28583850
Safety baseballs and chest protectors: a systematic review on the prevention of commotio cordis.
Classie JA, Distel LM, Borchers JR
Phys Sportsmed 2010 Apr;38(1):83-90. doi: 10.3810/psm.2010.04.1765. PMID: 20424405

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