Commotio cordis risk factors
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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
The risk factors for commotio cordis include the location and timing of the blow, the type of mechanical stimulus, age, chest morphology, and the hardness of the object involved in the impact. Understanding these risk factors can help in developing preventive measures and strategies to reduce the incidence of commotio cordis, especially in high-risk populations such as young athletes participating in sports with a higher potential for chest impacts. Certain sports have been identified as having a higher potential risk for commotio cordis such as Karate, Taekwondo, Judo, Kabedi, Free-style Wrestling, Cricket, baseball, hockey, lacrosse, and softball.
Risk factors
The type of the sports
Certain sports have been identified as having a higher potential risk for commotio cordis. Baseball, hockey, lacrosse, softball and combat sports such as Karate, Taekwondo, Judo, Kabedi, Free-style Wrestling, and Cricket have been associated with an increased risk of commotio cordis[1].
The location and timing of the blow
- The impact to the chest should be in a specific area and occur during a vulnerable phase of the cardiac cycle.
- The precise timing of the impact is crucial in determining whether ventricular fibrillation, the main arrhythmia associated with commotio cordis, occurs[2].
The type of mechanical stimulus
- Smaller, more compact objects that concentrate their energy on a smaller surface area (like a baseball or hockey puck) have been shown to increase the risk of mechanically induced arrhythmia[3].
Age and chest morphology
- Young age and a thin, undeveloped chest cage increase the vulnerability to this condition.
- The chest wall of children and young adults is more compliant and less able to absorb the impact, making them more susceptible to cardiac arrest[4].
The hardness of the object
- Softer baseballs have been shown to decrease the risk of commotio cordis compared to regulation balls.
- Safety baseballs, specifically designed to reduce the risk of commotio cordis, have been shown to be effective in experimental models[2][3].
References
- ↑ Halabchi F, Seif-Barghi T, Mazaheri R (March 2011). "Sudden cardiac death in young athletes; a literature review and special considerations in Asia". Asian J Sports Med. 2 (1): 1–15. doi:10.5812/asjsm.34818. PMC 3289188. PMID 22375212.
- ↑ 2.0 2.1 Link MS, Wang PJ, Pandian NG, Bharati S, Udelson JE, Lee MY, Vecchiotti MA, VanderBrink BA, Mirra G, Maron BJ, Estes NA (June 1998). "An experimental model of sudden death due to low-energy chest-wall impact (commotio cordis)". N Engl J Med. 338 (25): 1805–11. doi:10.1056/NEJM199806183382504. PMID 9632447.
- ↑ 3.0 3.1 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). - ↑ Maron BJ, Poliac LC, Kaplan JA, Mueller FO (August 1995). "Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities". N Engl J Med. 333 (6): 337–42. doi:10.1056/NEJM199508103330602. PMID 7609749.