CV

Commotio Cordis

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Commotio Cordis

  • Epidemiology
  1. Among the most common causes of Sudden Cardiac Death in athletes
  • Pathophysiology
  1. Blunt Chest Trauma at the Cardiac Cycle time of T-Wave
  2. Results in sudden cardiac depolarization with R on T phenomenon and pulseless Arrhythmia
    1. Ventricular Fibrillation (more common with high speed impact)
    2. Asystole
  • Management
  • Emergent
  1. ABC Management
  2. Blunt Chest Trauma
  3. Greatest chance of survival is for early cardiac Defibrillation within first 5 minutes
    1. Chance of survival <25% with Defibrillation delayed >5 minutes
  1. Electrocardiogram (EKG)
  2. Echocardiogram
  3. Telemetry (followed by outpatient Holter Monitor or Zio Monitor)
  • References
  1. Dreis (2020) Crit Dec Emerg Med 34(7):3-21