Commotio cordis primary prevention: Difference between revisions

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Revision as of 05:55, 29 August 2023

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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The prevention of commotio cordis is crucial in reducing the incidence of this life-threatening condition.

One preventive measure is the use of safety baseballs, which have been shown to reduce the risk of commotio cordis in experimental models. These safety baseballs are designed to be softer than regulation balls, and they have been recommended by the Consumer Product Safety Commission as a means to decrease injuries in youth baseball. Experimental models have demonstrated a relationship between the hardness of the baseball and the likelihood of ventricular fibrillation, the primary mechanism of commotio cordis.
Other preventive measures include the use of chest wall protectors. Chest wall protectors, such as those used in ice hockey, can help soften the impact of projectiles and reduce the induction of ventricular fibrillation. However, recent studies indicated that there is no clear evidence of the effectiveness of chest protectors in reducing the risk of commotio cordis.
Immediate initiation of cardiopulmonary resuscitation (CPR) and defibrillation is important in improving outcomes. Therefore, ensuring the availability of defibrillators at sporting events is essential in preventing deaths from commotio cordis.
Education and awareness among coaches, trainers, and participants in high-risk sports events are also important preventive strategies^[1]^[2]^[3].

↑ Menezes RG, Fatima H, Hussain SA, Ahmed S, Singh PK, Kharoshah MA, Madadin M, Ram P, Pant S, Luis SA (July 2017). "Commotio cordis: A review". Med Sci Law. 57 (3): 146–151. doi:10.1177/0025802417712883. PMID 28587536.
↑ Okorare O, Alugba G, Olusiji S, Evbayekha EO, Antia AU, Daniel E, Ubokudum D, Adabale OK, Ariaga A (April 2023). "Sudden Cardiac Death: An Update on Commotio Cordis". Cureus. 15 (4): e38087. doi:10.7759/cureus.38087. PMC 10209547 Check |pmc= value (help). PMID 37252546 Check |pmid= value (help).
↑ Matusak ME, Yau CC, Fibel KH (August 2023). "Medical Sports Injuries in American Football Players". HSS J. 19 (3): 277–284. doi:10.1177/15563316221144284. PMC 10331267 Check |pmc= value (help). PMID 37435128 Check |pmid= value (help).

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 == Resume of activities ==
-In order to rule out structural heart disease, commotio cordis patients must have a cardiac workup. This includes stress tests, ambulatory ECG monitoring, echocardiograms, magnetic resonance imaging, and ECGs. In the presence of characteristic electrocardiographic signs, pharmacological testing for Brugada and long-QT syndromes should also be taken into consideration. Even genetic testing might be taken into consideration when long-QT syndrome is a possible differential diagnosis. Implantable cardioverter defibrillators are not advised for commotio cordis survivors if there is no underlying cardiac illness  <ref name="pmid266216532" />
 == References ==