Commotio Cordis in a 17-Year-Old Baseball Catcher

An unusual case of commotio cordis resulting in ventricular flutter

“…Commotio cordis is the second most common cause of sudden death in young male athletes after hypertrophic cardiomyopathy. [ 2 4 ] The most frequent arrhythmia described is ventricular fibrillation leading to sudden death on initial presentation. [ 5 6 ] Victims typically collapse upon impact; 20% of patients remain conscious for several seconds and very few present minutes or hours after impact.…”

“…Determinants of injury include precordial location, repolarization phase, projectile density, and impact velocity (30–50 miles/h). [ 4 6 ] The vulnerable phase of repolarization occurs 10–20 ms before peak of the T wave[ 2 ] [ Figure 3 ]. Studies suggest that transmitted impact force causes myocardial ion channel upregulation and massive ion influx leading to arrhythmias such as ventricular fibrillation.…”

Baseball and Softball

“…76 Even the chest protectors for catchers, which are effective for blunting the usual forces encountered from pitches, foul tips, throws, and collisions do not reliably prevent commotio cordis. 24,77 Hard plastic shell batting helmets have long been an integral part of protecting baseball and softball players from head injuries while batting and running the bases. The NOCSAE developed standards for helmets and their testing decades ago.…”

Commotio cordis – under-recognized in Europe?: a case report and review

“…25 The use of precordial thump is questionable, also because it may convert an arrhythmia into a more malignant arrhythmia. 8,26 At present, precordial thump is not recommended in the case of SCA. This case report, however, may support the need for further studies to clarify the role of precordial thumps in future SCA recommendations.…”