Commotio Cordis or Disturbance of Heart - Research Paper Example

Commotio Cordis Commotio cordis is a Latin word with the meaning of “disturbance of heart.” This pathology was first analyzed in 1763. It results due to a traumatic injury to the heart mainly over the area of the precordium and mainly affects the athletes. It has been seen that almost sixty percent of the people who present with this condition have an underlying trauma to the chest during sports games. This pathological condition may affect either sex but it has a greater predilection towards males. Though it may affect any age group, the highest susceptibility is between the ages of 4 years to 15 years. Furthermore, a cricketer who died due to this condition was aged 43 years and he has been recognized to be the individual with the highest age who died due to this pathology. In the United States of America, there have been 190 people who have been affected with this condition. Baseball has been associated with the highest number of cases of this condition but other sports which include softball, lacrosse, hockey and soccer also lead to this pathology. Trauma to the chest wall during fist impact has also been reported. The trauma to the chest wall results in the alteration of the normal rhythmic heartbeat of an individual and the condition can prove to be fatal in almost 85 percent of the cases. It has been marked as the second leading reason of sudden cardiac death in the athletes (Bracker 2011; Thompson 2001). Commotio cordis is also referred to as cardiac concussion. Though the condition was described previously, the first case of this traumatic pathology came in the year 1978 when a young boy of 7 years died due to this condition. The boy died after he was hit bluntly on the chest wall by a shot of decreased energy. The identification of the pathology and its proper description led to the increase in the number of cases of this condition. The United States Consumer Safety Commission identified an important aspect in the year 1984 that during the game of baseball, fatalities were higher due to traumatic chest injury as compared to injuries to the head. The cardiac presentations of the condition include ST elevation on the ECG, abnormal rhythms of the heart, ventricular fibrillation, ventricular tachycardia as well as heart block. The main phenomenon is considered to be associated with trauma mainly to the left ventricle at a time of 10 to 30 milliseconds prior to the T elevation of the heartbeat which results in fibrillation of the ventricle. This results due to the effect on the potassium channels which are present in the left ventricle which get activated owing to solid impact. Furthermore, solid impact on the chest wall may also depolarize the ventricles and this is associated with irregular beats arising from the ventricle (Brugada 2010; Thompson 2001). The symptoms that the patients present with include loss of pulse and unconsciousness. They may present with cessation of breathing. They may also have grand mal seizures and they can develop instant cyanosis. Bruises at the site of the impact may also be seen. The susceptibility for the condition increases for people who take part in sports games that are associated with the condition. It is seen that the velocity of 30 mph to 50 mph provides for the highest probability of the development of the problem. There is no genetic predisposition for the condition but it has been clearly associated with a sexual predilection towards males. This may be due to certain genetic or hormonal differences from females. The younger age groups have a higher risk of suffering from commotia cordis. This is due to the fact that the chest wall is weaker in the younger age groups and has a higher elasticity. It is seen that with increasing age, the bones of the chest become stronger and can withhold stronger blows which tends to reduce the susceptibility (Bracker 2011; Panté 2009; Thompson 2001). The condition is treated immediately with the techniques of Advanced Cardiac Life Support. Cardiopulmonary Resuscitation should be started immediately following the condition. The probability of survival may be 25 percent only if resuscitation is started within a period of 3 minutes and the patient is defibrillated with an Automated External Defibrillator. The delay in these medical efforts to save the patient beyond 3 minutes may result in death. Thus this condition is a very dangerous pathology that needs to be identified immediately and treated as unwanted delay may result in fatality. Furthermore, even after survival the patient may present with complications. These include loss of function of the nervous system as well as an effect on the functional capacity of the left ventricle (Bracker 2011; Panté 2009). The lower identification and awareness regarding the condition can result in an increase in the reported cases. The continued use of the chest protectors that are available nowadays would also result in a higher number of fatalities due to commotio cordis. This is because the inefficiency of the chest protectors can be analyzed by the fact that 40 percent of fatalities that have resulted due to commotion cordis result in people who already wear them while playing games. If the quality of the balls used in the games also remains the same, the cases would tend to increase (Brugada 2010; Lawless 2010). Safe balls should be used in all the games which should be designed according to specific age groups. This should be true not only for the professional level but also for the domestic games. The susceptibility of the condition may also be decreased by means of altering a few moves and shots in the game along with proper coaching practice to avoid such shots which result in chest blows. The people playing the games should be given stronger skills so that they can overcome such blows. The protectors for these games should be designed in advanced ways so that they truly function towards the prevention of chest injuries. The training of Cardiopulmonary Resuscitation should be increased so that athletes as well as coaches are aware of the technique so that immediate support can be provided. Early resuscitation, proper chest protectors and the wide understanding of the disease can be of assistance in improving the outcome of the patients and prevent the fatalities resulting from commotio cordis (Lawless 2010). Works Cited Top of Form Bracker, M. D. (2011). The 5-minute sports medicine consult. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Top of Form Brugada, R. (2010). Clinical Approach to Sudden Cardiac Death Syndromes. London: Springer-Verlag London Limited. Top of Form Lawless, C. E. (2010). Sports cardiology essentials: Evaluation, management and case studies. New York: Springer. Bottom of Form Top of Form Panté, M. D. (2009). Assessment and treatment of trauma: ALS edition. Boston: Jones and Bartlett Publishers. Bottom of Form Bottom of Form Bottom of Form Top of Form Thompson, P. D. (2001). Exercise and sports cardiology. New York: McGraw-Hill, Medical Pub. Division. Bottom of Form Read More