What is commotio cordis, and how common is it?
Dr. Lorenzoni: First, we do not know for sure that what we saw in the Buffalo Bills game was commotio cordis, but it is a likely diagnosis. Commotio cordis can be a cause of something called “sudden cardiac death”, which is a category of emergencies that often involve an abnormal heart rhythm and can lead to cardiac arrest. This is a bit different than what usually happens during a “heart attack” that we might be more familiar with.
Commotio cordis is extremely rare. Out of the millions of athletes in this country, only about 30 cases are reported each year. Commotio cordis affects mostly male athletes 8 to 20 years old who are in activities that could involve a strong impact to the chest. On average, only about 50% of people survive. You can increase the chances of survival with quick treatment, like we saw with Damar Hamlin.
It’s important to understand that you are not “born with” commotio cordis. It is not a type of heart disease, and it is not genetic or inherited. It can occur in anyone who gets hit hard in the front of the chest, but it happens more often in older children and young adults who are in these types of activities.
How exactly does the injury resulting in commotio cordis play out on the field?
Dr. Pacicca: As Dr. Lorenzoni mentioned, commotio cordis is extremely rare. Here’s why:
You’d have to get hit in the front of the chest, right over the heart. Quick blast from the past from high school biology… your heart is in the center-left part of your lower chest. The risky area of the chest is only a couple inches wide. This is getting pretty precise.
Explain “getting hit in the chest.” What does that look like?
Dr. Pacicca: Athletes can experience commotio cordis from things like a baseball, a hit during football (as we know), a hockey puck, or a lacrosse ball. The force has to be pretty strong, typically an object travelling more than 30 miles per hour or an unlucky tackle.
