Commotio cordis causes the heart to stop beating after taking a blow to a specific spot on the chest from a hard object striking at a precise time during the heartbeat.

Published: January 5, 2023

Commotio cordis causes the heart to stop beating after taking a blow to a specific spot on the chest from a hard object striking at a precise time during the heartbeat, according to a heart rhythm specialist at Norton Heart & Vascular Institute.

“It’s very rare because of all of these things that have to line up and happen at the exact right time, said Tara U. Mudd, APRN, nurse practitioner with the Norton Heart & Vascular Institute Heart Rhythm Center.

It’s more likely to occur in athletics when a small, hard object like a baseball or hockey puck strikes just above the heart’s location in the chest, according to Tara.

“Those affected by commotio cordis are often younger,” Tara said. “In adults, you have a larger chest size, and it’s much less pliable, offering more protection to the chest cavity.”

Because the first and often only symptom is cardiac arrest, athletic trainers are often the first responders and can administer cardiopulmonary resuscitation (CPR) as well as use an automated external defibrillator (AED) to help restart the heart. Athletic trainers practice regularly to assist with lifesaving first aid.

Survival of commotio cordis has improved dramatically in recent years as CPR training has expanded and AEDs have become more widely available at athletic events.

“If you do not know CPR, learn CPR,” Tara said. “Pay attention to where your AEDs are in any scenario: the grocery store, the airport, your doctor’s office. Just being aware of those things really can help save someone’s life.”

While young athletes can be more susceptible to the condition, it is very rare and any risk of experiencing commotio cordis cannot be predicted and won’t show up on a routine pediatric or other medical exam, according to Soham Dasgupta, M.D., a pediatric cardiologist at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine.

Families don’t need to worry too much about the condition, but should be aware and know what to do in an emergency, according to Dr. Dasgupta.

“It’s all about awareness and having the right tools at the right moment,” he said, referring to CPR and AEDs. “This is an earnest request to all schools to have working AEDs and make sure that there’s someone nearby trained to use an AED.”