Commotio cordis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2]

Overview

Generally, it is assumed that if commotio cordis is successfully treated and recovered, no further heart complications will develop.
A study demonstrated that out of the total cases of commotio cordis with particularly prompt cardiopulmonary resuscitation/defibrillation, 71% experienced a full physical recovery, while the remaining 29% exhibited mild to moderate residual neurological disability or cardiac impairment (noted through a decrease in left ventricular ejection fraction) during the follow-up period spanning from 1 to 20 years^[1].

Commotio cordis has a poor prognosis with only a small number of these victims surviving after immediate resuscitation. A continuous rise of survival rates due to commotio cordis is evident, shifting from 10%–15% before the year 2000 to more than 50% in 2012 l^[2].

There is a 10 percent decline in survival rate in the first minute following the loss of consciousness. Five percent decline in survival rate in each following minute following the loss of consciousness^[2].

↑ Maron BJ, Gohman TE, Kyle SB, Estes NA, Link MS (March 2002). "Clinical profile and spectrum of commotio cordis". JAMA. 287 (9): 1142–6. doi:10.1001/jama.287.9.1142. PMID 11879111.
↑ ^2.0 ^2.1 Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Estes NA, Link MS (February 2013). "Increasing survival rate from commotio cordis". Heart Rhythm. 10 (2): 219–23. doi:10.1016/j.hrthm.2012.10.034. PMID 23107651.