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Sports Medicine Moment: Cardiac Conditions – Commotio Cordis

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Sports Medicine Moment: Cardiac Conditions – Commotio Cordis

Written by: Tristen Robinson

Tristen Robinson, M.S., ATC, LAT is a BUZZ Gear Up Blogger and an instructor at Andrew Jackson High School, for the sports medicine magnet program. Checkout the program’s Facebook page at Andrew Jackson High School Sports Medicine. https://www.Facebook.com/Jacksonsportsmed/

 

As we continue on with the heart theme for this month, our next topic for discussion is Commotio Cordis (CC). This condition may be unfamiliar to some, but is one that is important to be aware of in the sports medicine world. More specifically, when working with young and adolescent athletes, CC is a condition that is of the highest awareness for a sports medicine professional (Athletic Trainer, Physical Therapist, MD).

For those that are not familiar with CC, let’s first define the condition. According to studies published, CC is blunt, non-penetrating trauma to the chest that results in irregular heartbeat; often times ending in sudden death. Blunt, non-penetrating trauma can be from an object such as a baseball or softball, or it can be from a body part (e.g. foot or elbow). Almost half of all CC cases occur during competitive sports between the ages of 4 – 18. This is due to the increased chest wall malleability. Before you get up at arms and remove your child from baseball or karate, it is important to understand how CC can occur.

Certain variables have to be present before the possibility of CC is considered. First is the age range is mentioned previously. Next is the actual sport. One study found that the top three sports in which CC occurs are, baseball, softball, and hockey. Another variable is the make-up of the blunt object. Typically, the harder the object (i.e. baseball, softball, soccer ball, etc.), the increased likely CC could occur if hit in the chest with that object. The last two variables are how fast the object is projecting and the location of the chest that it hits. One study found that the blunt projectile would have to be traveling between speeds of 30 – 50 mph. Lastly, for CC to be a possibility, the blow would have to occur directly over the heart.

As with sudden cardiac arrest, CC does not have any signs or symptoms that could be used to prevent the condition. Fainting, collapse, and possibly loss of consciousness, directly follow a blow to the chest over the heart. Early and immediate recognition and action are the saving grace to increase likelihood of survival. Immediate activation of 911, as well as CPR and AED use, make for an increased chance for a happy ending. When possible, appropriate protective chest equipment should be worn during competition. Easy access to an AED, in addition to an appropriate health care professional (Athletic Trainer, Physical Therapist, etc.) can place you on the more favorable end of a CC event. To read more about commotio cordis, please visit:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445066/

 

This has been your sports medicine moment…