title: Dangerous impact--commotio cordis.
abstract: Sudden death following blunt chest trauma is a frightening occurrence known as 'commotio cordis' or 'concussion of the heart'. It is speculated that commotio cordis could be caused by ventricular fibrillation secondary to an impact-induced energy that was transmitted via the chest wall to the myocardium during its vulnerable repolarization period. We describe a survivor of commotio cordis caused by a baseball. In this patient, an initial ventricular fibrillation was documented and converted by direct current defibrillation. Serial electrocardiographic changes (bifascicular conduction block and T wave inversion in precordial leads) were noticed in this patient. Our case suggested that coronary vasospasm might also play a role in commotio cordis.
authors.affiliation: Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
authors.forename: J N
authors.initials: JN
authors.lastname: Wang
authors.forename: Y C
authors.initials: YC
authors.lastname: Tsai
authors.forename: S L
authors.initials: SL
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: C S
authors.initials: CS
authors.lastname: Lin
authors.forename: J M
authors.initials: JM
authors.lastname: Wu
mesh_terms: D001484:Baseball / Q000293:injuries*; D002037:Bundle-Branch Block / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016887:Cardiopulmonary Resuscitation; D002648:Child; D004452:Echocardiography; D004554:Electric Countershock; D004562:Electrocardiography; D006335:Heart Injuries / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006801:Humans; D008297:Male; D014693:Ventricular Fibrillation / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000503:physiopathology / Q000628:therapy