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Instantaneous cardiac arrest caused by a blow to the chest depends on the timing of the blow relative to the cardiac cycle
Sudden death following a sharp but seemingly inconsequential blow to the chest is a frightening occurrence known as “commotio cordis” or “concussion of the heart.” Although commotio cordis is considered rare by some authors, it represents one of the most common mechanisms of sudden death in sport seen in young athletes.1
Commotio cordis is generally understood to mean “instantaneous cardiac arrest produced by non-penetrating chest blows in the absence of heart disease or identifiable morphologic injury to the chest wall or heart”.2,3 Most cases report accidental death of otherwise healthy children or adolescents after chest impact during recreational or competitive sport or, less commonly, during road traffic accidents.4–9
Such fatalities receive extensive media coverage, provoke legal debate, and may stimulate research into the public health aspects of this condition—for example, the capacity of protective gear to prevent commotio cordis or the possibility of developing safer sporting equipment.10
The current concept of commotio cordis is often ascribed …
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