Commotio cordis: A review

Commotio cordis is an increasingly reported fatal mechano-electric syndrome and is the second most common cause of sudden cardiac death in young athletes. It is most commonly associated with a sports-related injury, wherein, there is a high-velocity impact between a projectile and the precordium. By virtue of this impact, malignant arrhythmias consequently develop leading to the individual’s immediate demise, accompanied by a relatively normal post-mortem analysis. The importance of an autopsy remains paramount to exclude other causes of sudden death. With increasing awareness and reporting, survival rates are beginning to improve; however, prevention of the development of this condition remains the best approach for survival.

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Commotio cordis: sudden cardiac death in athletes

American Journal of Critical Care ◽

10.4037/ajcc1999.8.4.270 ◽

1999 ◽

Vol 8 (4) ◽

pp. 270-272 ◽

Cited By ~ 9

Author(s):

LG Futterman ◽

L Lemberg

Keyword(s):

High School ◽

Sudden Cardiac Death ◽

Blunt Trauma ◽

Cardiac Death ◽

The Other ◽

High School Athletes ◽

Young Athletes ◽

The Public ◽

High Profile ◽

Commotio Cordis

Commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Several measures, such as the use of safety baseballs and the use of chest protectors, can help protect young athletes from commotio cordis. In general, sudden cardiac death in athletes is receiving increasing attention from the public as a result of recent deaths of high-profile athletes. Sudden cardiac death, however, is rare, with an estimated 1 out of 200,000 high school athletes at risk each year. However, the personal, physiological, and cardiovascular benefits of athletics far outweigh the risks. Therefore, the message to parents is to allow their children to participate in athletics because the benefits far outweigh the risks.

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Comparison of variant detection rate in genes between two cohorts of Czech living patients versus victims of sudden cardiac death with clinical / post mortem diagnosis of non-ischemic cardiomyopathy

European Heart Journal ◽

10.1093/ehjci/ehaa946.0338 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Borisincova ◽

P Votypka ◽

K Rucklova ◽

A Pilin ◽

M Kulvajtova ◽

...

Keyword(s):

At Risk ◽

Czech Republic ◽

Primary Prevention ◽

Sudden Cardiac Death ◽

Genetic Counselling ◽

Cardiac Death ◽

Detection Rate ◽

Funding Source ◽

Post Mortem ◽

Custom Made

Abstract Introduction Hereditary cardiomyopathy is associated with an increased risk of ventricular arrhythmia and sudden cardiac death (SCD). Genetic stratification substantiates risk assessment and enables the primary prevention of SCD in relatives at risk. We have analyzed the genetic aetiology of SCD in a representative Czech cohort with post mortem diagnosis of various forms of cardiomyopathy and compared it to living cases with these cardiac disorders. Patients and methods Between 2018 and 2019, altogether 47 victims of SCD with post mortem diagnosis of hypertrophic- (HCM; 18/47), arrhythmogenic- (ACM; 19/47) and dilated cardiomyopathy (DCM; 10/47) were identified. Concurrently, genetic testing was performed in 114 living patients (HCM 54/114, ACM 22/114, DCM 38/114). Genetic counselling and cardiologic examination had been carried out in first-degree relatives in all patients/SCD victims. Massively parallel sequencing (MiSeq platform; Illumina.com) was utilized for a custom-made panel comprising 100 candidate genes (Sophia Genetics, Switzerland). The presence of pathogenic variants was validated by Sanger DNA sequencing and through family segregation analyses. Results The causative detection rate (according to ACMG.net classes 4 or 5) in SCD victims with DCM was 60% (6/10) and in living patients with DCM 47.4% (18/38). Variants in TTN, RBM20, DES and FLNC (mainly truncating variants) prevailed in both groups. The detection rate in ACM was 5% (1/19 in SCN5A gene) in SCD victims and 31.8% (7/22) in living patients. Interestingly, the most prevalent mutated gene PKP2 in living patients was not detected in SCD victims. The detection rate in SCD victims with post mortem diagnosis of HCM was 16% (3/18) and in living patients 35% (19/54). The most prevalent gene was MYBPC3 in both groups, while PRKAG2 was detected in one SCD victim and in one living case who survived cardiac arrest. Conclusion Post-mortem genetic analysis in DCM yields a high detection rate and allows potentially effective primary prevention of SCD in relatives at risk. In contrast, the molecular autopsy of HCM and ACM renders a much lower yield which is below the mutation detection rate in living phenotype positive individuals. The results help to improve the genetic counselling in affected families in Czech Republic. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of Health of the Czech Republic

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Blow/trauma to the chest and sudden cardiac death: Commotio cordis and contusio cordis are leading causes

Medicine Science and the Law ◽

10.1177/0025802418754961 ◽

2018 ◽

Vol 58 (2) ◽

pp. 93-96 ◽

Cited By ~ 2

Author(s):

Lydia Krexi ◽

Mary N Sheppard

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Traffic Accidents ◽

Left Ventricular ◽

Young Males ◽

Contusio Cordis ◽

Commotio Cordis ◽

Forensic Practice ◽

Acute Changes ◽

The Right

Background In forensic practice, a blow to the chest can lead to sudden cardiac death (SCD). Commotio cordis and contusio cordis are leading causes. Methods From a database of 4678 patients who suffered from SCD, we found three patients with commotio cordis and two patients with contusio cordis. All the patients were examined macroscopically and microscopically and had negative toxicology screen. Results The three patients who died due to commotio cordis were young males (16, 23 and 38 years old). The circumstances of death were: a blow to the chest by a football, by a friend during a party and during an assault. The hearts were completely normal at autopsy. The two patients who had contusio cordis were older males (42 and 63 years old). Both patients died during traffic accidents. At autopsy, one had significant contusion over the left ventricle, and the second had contusion over the right ventricle. Conclusion This study indicates that a blow to the chest is very important to document in the circumstances of death, and a detailed history is vital. It raises the left ventricular intra-cavitary pressure, leading to commotio cordis with immediate death with a normal heart. Blunt chest trauma can cause direct myocardial lesions, with acute changes leading to contusio cordis.

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Arrhythmias in dialysis patients

In a good rythm ◽

10.5604/01.3001.0014.7471 ◽

2021 ◽

Vol 4 (57) ◽

pp. 8-11

Author(s):

Szymon Warwas ◽

Marta Jagosz ◽

Beata Średniawa ◽

Michał Mazurek ◽

Ewa Jędrzejczyk-Patej

Keyword(s):

Cardiovascular Diseases ◽

Sudden Cardiac Death ◽

Kidney Disease ◽

Cardiac Death ◽

Ventricular Arrhythmias ◽

Dialysis Patients ◽

End Stage Kidney Disease ◽

Common Cause ◽

Conduction Disturbances ◽

End Stage

The most common cause of death among dialysis patients with end-stage kidney disease are cardiovascular diseases. It is estimated that 18-27% of all deaths in dialysis patients are sudden cardiac deaths due to arrhythmias and conduction disturbances. The most common arrhythmias in dialysis patients, often leading to sudden death, are not ventricular arrhythmias but bradyarrhythmias. The article below discusses the most common arrhythmias in dialysis patients and methods of preventing sudden cardiac death in this group of patients.

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