Commotio cordis

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Commotio cordis (Latin, "agitation / disruption of the heart") is a disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (the precordial region) at a critical instant during the cycle of a heartbeat. The resulting sudden rise in intracavitary pressure leads to disruption of normal heart electrical activity, followed instantly by ventricular fibrillation, complete disorganization of the heart's pumping function, and cardiac arrest. It is not caused by mechanical damage to the heart muscle or surrounding organs and is not the result of heart disease. The incidence of commotio cordis in the United States is fewer than 20 cases per year. It often occurs in boys participating in sports, most commonly in baseball when a ball strikes a player in the chest. Its rareness arises because it can occur only upon impact within a window of about 40 milliseconds in the cardiac electrical cycle. The condition has a 97% fatality rate if not treated within three...

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