NEPA Vital Signs - Summer Fall 2018 - 24

L ACKMEDSOC.ORG

LUZERNEMEDSOC.ORG

Feature

WRONG PLACE, WRONG TIME
Blunt Chest Wall Trauma Can Result in
Sudden Cardiac Death in Young Athletes
AST YEAR, NANCY CROWLEY ALMOST LOST HER 14-YEAR-OLD SON.

of an emergency response system (911),

She had sent him to a batting cage 90 feet from where she was sitting while she and a comprehensive cardiac evaluation
watched her other son's baseball game. In that moment, her son was struck prior to participation in sporting events,
by a ball in the chest and collapsed. Commotio cordis nearly took his life.
the ACC recommended the use of age

Commotio cordis is an abnormal heart
rhythm, often fatal, that results from a blunt
force to the chest. It is the second leading
cause of death in young athletes, and most
commonly affects males between 8 and
19 years old. It often results from a ball
striking the chest at a speed greater than
20 miles per hour. This type of injury most
commonly occurs in baseball players. The
problem is incompletely understood, but
thought to be related to stretch-sensitive
ion channels in the heart cells.
The US Commotio Cordis Registry has
been collecting data on this devastating
injury since the 1970s. As recently as the
1990s, the event was almost universally

fatal with sudden death occurring in more
than 85% of events. In the mid-1990s and
more recently in the 2000s, we have seen
a more rapid increase in survivorship and
in the last decade, survivorship surpassed
deaths. This is thought to be related to
increased awareness, more CPR training
and knowledge, and availability of AEDs,
as well as rapid response time of immediate responders.
While recognition and treatment are
important, prevention is key. In 2015, the
American College of Cardiology (ACC)
released recommendations regarding
Commotio cordis. In addition to training
staff about CPR and AED, early activation

N E PA

VITAL SIGNS

appropriate safety balls to reduce risk of
injury and assessing and adjusting rules
and teaching coaches to reduce risk of
injury through technique. Additionally,
Healthcare Journal describes anticipated
market growth amplified from 2017-2025
in the field of catcher chest protection.
While commotio cordis is not unique
to baseball, the equipment used for the
catcher position may serve as a model for
future development. In 2017, researchers
in Boston, MA studied more than 10 combinations of chest protector materials. In
their paper published in Clinical Journal
of Sports Medicine in January 2017, they
concluded thickness of the protector was
most related to protection from commotion
cordis, but material didn't matter.

http://www.lackmedsoc.org http://www.LUZERNEMEDSOC.ORG

Table of Contents for the Digital Edition of NEPA Vital Signs - Summer Fall 2018