Commotio cordis primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2]
Overview
There are different measures to prevent or reduce the risk of commotio cordis. One preventive measure is the use of safety baseballs which are softer than regular balls. Other preventive measures include the use of chest wall protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis. Also, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis. Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies. the decision to return to sports after experiencing commotio cordis should be carefully evaluated on an individual basis, considering factors such as the underlying cause of the event, the severity of the injury, and the presence of any underlying cardiac conditions.
Primary Prevention
The prevention of commotio cordis is crucial in reducing the incidence of this life-threatening condition.
- One preventive measure is the use of safety baseballs, which have been shown to reduce the risk of commotio cordis in experimental models. These safety baseballs are designed to be softer than regular balls, and they have been recommended by the Consumer Product Safety Commission as a means to decrease injuries in youth baseball. Experimental models have demonstrated a relationship between the hardness of the baseball and the likelihood of ventricular fibrillation, the primary mechanism of commotio cordis.
- Other preventive measures include the use of chest wall protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles and reduce the induction of ventricular fibrillation. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis.
- Immediate initiation of cardiopulmonary resuscitation (CPR) and defibrillation is important in improving outcomes. Therefore, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis.
- Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies[1][2][3].
Resume of activities
The decision to return to sports after experiencing commotio cordis should be made on an individual basis, taking into account factors such as:
- The underlying cause of the event
- The severity of the injury
- the presence of any underlying cardiac conditions
It is recommended that athletes who have experienced commotio cordis undergo a comprehensive evaluation by a healthcare professional with expertise in sports cardiology. This evaluation may include a thorough medical history, physical examination, electrocardiogram (ECG), echocardiogram, and exercise stress testing.
In some cases, it may be necessary to restrict or modify sports participation to reduce the risk of recurrent commotio cordis. This may involve avoiding high-velocity moving projectiles or contact sports that pose a higher risk of chest trauma. The decision to return to sports should be made in collaboration with the athlete, their family, and their healthcare team, taking into consideration the individual's goals, preferences, and overall health status[2].
References
- ↑ Menezes RG, Fatima H, Hussain SA, Ahmed S, Singh PK, Kharoshah MA, Madadin M, Ram P, Pant S, Luis SA (July 2017). "Commotio cordis: A review". Med Sci Law. 57 (3): 146–151. doi:10.1177/0025802417712883. PMID 28587536.
- ↑ 2.0 2.1 Okorare O, Alugba G, Olusiji S, Evbayekha EO, Antia AU, Daniel E, Ubokudum D, Adabale OK, Ariaga A (April 2023). "Sudden Cardiac Death: An Update on Commotio Cordis". Cureus. 15 (4): e38087. doi:10.7759/cureus.38087. PMC 10209547 Check
|pmc=value (help). PMID 37252546 Check|pmid=value (help). - ↑ Matusak ME, Yau CC, Fibel KH (August 2023). "Medical Sports Injuries in American Football Players". HSS J. 19 (3): 277–284. doi:10.1177/15563316221144284. PMC 10331267 Check
|pmc=value (help). PMID 37435128 Check|pmid=value (help).