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January 28, 2023

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What is commotio cordis? Explaining sudden heart stoppage that ‘likely’ led to Damar Hamlin going into cardiac arrest

Source: sportingnews.com

Second-year Bills safety Damar Hamlin is in critical condition at the University of Cincinnati Medical Center after collapsing on the field during Buffalo’s “Monday Night Football” contest against the Bengals.

Hamlin required immediate medical attention on the field at Paycor Stadium following a seemingly routine tackle of Cincinnati receiver Tee Higgins. The two collided after a Higgins reception in the first quarter, with Hamlin taking the brunt of the hit to his chest; after getting up from the tackle, the second-year safety from Pitt collapsed onto his back.

Hamlin received immediate medical attention on the field before being transported to the hospital via ambulance. The NFL eventually suspended the game, an unprecedented move, with players and coaches from both teams in obvious distress. Now the world awaits word on his condition.

The Bills released a statement early Tuesday morning saying Hamlin had suffered cardiac arrest. Multiple physicians unconnected to Hamlin’s specific case spoke out on social media and television, saying the 24-year-old’s collapse probably resulted from commotio cordis, which occurs when blunt force to the chest interrupts an otherwise-normal heartbeat.

What is commotio cordis?

The Mayo Clinic defines commotio cordis as “a hard hit to the chest that causes sudden cardiac death.” The latin meaning for the term is “agitation of the heart.”

Below is a more detailed definition, via the Mayo Clinic:

Commotio cordis may occur in athletes who are hit hard in the chest by sports equipment or by another player. This condition doesn’t damage the heart muscle. Instead, it changes the heart’s electrical signaling. The blow to the chest can trigger ventricular fibrillation if it strikes at a specific time in the signaling cycle.”

Dr. Manesh Patel, chief of cardiology and clinical pharmacology at Duke University, told The Sporting News that Hamlin’s cardiac arrest “likely” was a result of commotio cordis.

Said Patel: “It is hard to speculate exactly what happened, but there is a clinical condition that is called commotio cordis, which is where when you get a blunt trauma to the chest, and it happens unfortunately just at the exact time the heart is repolarizing, or going from a squeezing state back to a resting state and back to a squeezing state, that can cause ventricular fibrillation.”

The Mayo Clinic defines ventricular fibrillation as a type of irregular heart rhythm. During ventricular fibrillation, “the lower heart chambers contract in a very rapid and uncoordinated manner. As a result, the heart doesn’t pump blood to the rest of the body.”

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