Sudden unexpected cardiac death that occurs in young people during sports participation is usually associated with previously diagnosed or undiagnosed structural or primary electrical cardiac abnormalities. Examples of such abnormalities include hypertrophic cardiomyopathy, anomalous origin of a coronary artery, arrhythmogenic right ventricular cardiomyopathy, and primary electrical disorders, such as congenital prolongation of the QTc interval and catecholaminergic, polymorphic ventricular tachycardia (CPVT). Sudden death due to ventricular fibrillation may also occur following a blunt, nonpenetrating blow to the chest, specifically the precordial area, in an individual with no underlying cardiac disease. This is termed commotio cordis.

SYMPTOMS

After being hit in the chest, a person with commotio cordis may stumble forward and lose consciousness. The injury won’t show any outward trauma to the chest. There may not be a bruise or any indication of a serious blow.

CAUSES

Just getting hit in the chest isn’t enough to cause commotio cordis. The timing of the blow must be at a precise moment during a heartbeat and strike an area near the centre of the heart left ventricle. The left ventricle is the lower left chamber of the heart.

This can trigger ventricular tachycardia. Ventricular tachycardia refers to a fast, irregular beating of the heart in the lower chambers. This is a serious condition. The same type of contact to the chest a moment later or an inch to one side may be nothing but harmless contact.

Some of the main causes of commotio cordis include being hit by a:

  • baseball
  • lacrosse ball
  • hockey puck
  • hockey stick 
 COMPLICATIONS

Successful treatment and recovery from commotio cordis may result in no further heart problems. You may, however, need an electrocardiogram to check your heart for any rhythm disturbances and a doctor’s approval before you’re cleared to play sports again.