21 June 2023

Commotio cordis is a rare and often fatal arrythmia in the heart that is caused by a blunt, nonpenetrating, impact to the chest despite the absence of direct structural damage.

Despite commotio cordis receiving a great deal of media coverage – particularly after NFL player Damar Hamlin collapsed during a game on live national television, requiring CPR and a defibrillator to restart his heart into normal rhythm – there is a lack of public awareness about the dangers of commotio cordis off the sporting field and the dangers it presents in our everyday lives.

New research has revealed that despite a greater proportion of cases occurring on the sporting field compared to non-sport related events (64 per cent and 36 per cent), non-sporting related incidents have a significantly higher mortality rate – 66 per cent mortality on-filed compared to 88 per cent mortality off-field, likely due to lower incidents of CPR, defibrillation, and automated external defibrillator availability.

A team of researchers, led by principal investigator Associate Professor Han Lim at the Department of Cardiology, Austin Health, have completed a new study titled Commotio Cordis in Non–Sport-Related Events: A Systematic Review which has highlighted the need for more public awareness.

The research found that more than one-third (36 per cent) of reported commotio cordis events occurred in non-sporting contexts, including assault, motor vehicle accidents, and daily activities.

Of the non-sport-related incidents, the primary cause of commotio cordis was assault, accounting for 76 per cent of cases. The majority of victims in those cases were female (86 per cent).

Incidents during 'daily activities', which account for 16 per cent of off-field incidents, include typical falls, play fighting in children, and occupational accidents.

Of the cases that did occur on the sporting field, baseball and softball were the most prominent sporting activities taken place, accounting for more than half of all incidents (56 per cent). American Football accounted for nine per cent, lacrosse eight per cent and hockey accounted for seven per cent. Two-thirds of all incidents occurred at a competitive level of play.

Though commotio cordis is not caused by direct physical damage to the heart or surrounding structures, it occurs as a result of an interference, such as a forceful impact, at a particular point during a heartbeat, causing it to enter a dangerous and irregular rhythm.