Physician Outlook Commotio Cordis

Commotio Cordis? Damar Hamlin

This article was written on Monday January 2, 2023 as Damar Hamlin's condition is being reported as being in "critical condition" following his collapse on the football field in Cincinatti Ohio. No information is known about the cause of his collapse at the time that this article was published.



Many families, including my own, spent the evening of the 2nd of January of 2023 gathered around the television watching NFL’s Monday night football game between the Buffalo Bills and Cincinnati Bengals. It was with shock and horror that we witnessed the sudden collapse of 24-year-old Buffalo Bills rookie safety Damar Hamlin after a first-quarter tackle against Tee Higgins.  Hamlin stood up briefly before falling unconscious. Nine very long minutes of cardio-pulmonary resuscitation were performed before he was taken off the field by an ambulance. Players from both teams were visibly upset and confused by the sequence of events and the vast majority of players appeared to be palpably relieved when the game was officially postponed. 

Although the cause of Hamlin’s collapse is unknown at this time, it is possible that Damar’s collapse is due to a life-threatening arrhythmia known as COMMOTIO CORDIS.  

Commotio Cordis is a very rare condition that primarily affects young male athletes. It is a condition most commonly seen in baseball, hockey or lacrosse players when a high-velocity projectile hits the athlete in the chest wall above the heart and causes a disturbance in the heart’s electrical rhythm.  The condition is much less common in football players as their chest wall is protected by pads and heavy gear.

Without immediate CPR and defibrillation, the prognosis of commotio cordis is not good.  This condition is extremely dangerous with rare survival if prompt defibrillation and ROSC (restoration of spontaneous circulation) is not established. 

A person who has commotio cordis can briefly stumble forward before losing consciousness. There is not usually any visible outward trauma or bruising of the chest wall.  The patient with commotio cordis is pulseless and stops breathing, as the injury causes the heart to stop pumping blood effectively. The rhythm present on EKG is known as ventricular fibrillation, which is almost universally fatal if an Automatic Electrical Defibrillator (AED) is not promptly applied and utilized to convert the ventricular fibrillation rhythm into a perfusing rhythm. 

Dr. Brian Sutterer (Sports Medicine specialist) does a great job explaining the COMMOTIO CORDIS in this clip.

Our thoughts and prayers are with Damar Hamlin and his family.



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