title: Commotio cordis without arrhythmic event and resuscitation: ECG, echocardiographic, angiographic and cardiovascular resonance imaging study.
abstract: We describe a case of commotio cordis in which the patient had an extensive cardiac evaluation, including ECGs, a coronary angiogram, a left ventriculogram, repeated echocardiography and cardiovascular MRI (CMRI). A healthy 17-year-old boy sustained an open-handed blow to the anterior part of the chest from a friend with whom he was playing. On admission ECG was performed that showed ST-T alterations and a TNI increase, with echocardiographic evidence of a localised pericardial effusion associated with a persistent myocardial blush at selective angiography. In addition, CMRI confirmed a local delayed enhancement in the same zone. An echocardiogram examination performed 30 days after discharge showed a complete disappearance of pericardial effusion and an improvement on ECG alterations. This is the first case report of a patient with commotio cordis, who did not show any arrhythmias and did not receive any resuscitation procedure, and was extensively studied by imaging methods.
authors.affiliation: Department of Cardiology, G.F. Ingrassia Hospital, Palermo,  Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Maringhini
authors.forename: Sergio
authors.initials: S
authors.lastname: Fasullo
authors.forename: Gabriella
authors.initials: G
authors.lastname: Vitrano
authors.forename: Gabriella
authors.initials: G
authors.lastname: Terrazzino
authors.forename: Filippo
authors.initials: F
authors.lastname: Ganci
authors.forename: Salvatore
authors.initials: S
authors.lastname: Paterna
authors.forename: Pietro
authors.initials: P
authors.lastname: Di Pasqual
mesh_terms: D000293:Adolescent; D056104:Commotio Cordis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D004562:Electrocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012151:Resuscitation; D014463:Ultrasonography