Thursday, November 18, 2010

Commotio Cordis (an uncommon but fatal sports injury)

Theory has it that a sharp blow to the sternum, delivered at just the right nanosecond in the cardiac cycle, will send the heart into ventricular fibrillation and the person so struck will die unless prompt CPR and defibrillation is performed. These days that means having a paramedic crew or an AED nearby and someone who recognizes the injury.

The video below is not a fake, and yes, there is some thought that this phenomenon is behind the martial arts legend of the 'dim mak' or 'death blow'. I have never witnessed commotio cordis, and do not wish to, but any of us could see it, and it's important to know what to do. CPR, and shock or that's all she wrote.

Interestingly, the 'sternal thump' or 'precordial thump' has been a technique that has been successful in a small percentage of patients in aborting a Vfib arrest. The physical blow to the sternum does deliver energy to the heart, but the real juice is much better. I HAVE done the precordial thump once, and it was successful for a few seconds in actually waking the patient from death, but alas, the patient went right back into a deadly rhythm and we could never get him back.


  1. When Uncle Sam was teaching us CPR thirty years ago (and I was NOT yet in any medical field or trained in such), the Army version of CPR lead us off with a sharp, intense pre-cordial thump. No clue if it worked, but it WAS Army policy!!

  2. Just like those sissy Martial Arts Homos, goin into a cardiac arrest from a simple chest thumpin'. My sister used to give me kicks to the groin worse than that, and did I curl up like a baby and cry?? OK, yes, but my heart didn't fibrillate.
    and When I was a kid, used to get forearm shivers up side' my haid' just for tryin to get my Moms German Shephard 'Blondi" to eat her horrible chopped liver...
    and my Dad was even worse, teaching us that New Fangled "Heimlich" maneuver by actually doing the Heimlich maneuver, and did you know a ruptured diaphragm will heal on its own without surgery? Or at least mine did...


  3. Bitch, bitch, bitch. I used to just TRY to get my Mom's German Shepherd, Blondi, to play with me by smearing Mom's horrible chopped liver over my legs, then running away. The dog ignored me and it turned out only the fire ants liked that stuff.

  4. When I was a young boy, I was pitching in a softball game in elementary school when I was hit by a line-drive right in the sternum. I lost consciousness and when I came to, I was tingly all over and I heard one of my female classmates ask, "Is he dead?" My teacher carried me in her arms to the school nurse, where I had to lie down for the rest of the period and drink water. When the bell rang, I went back to class. I felt fine and my parents were never informed as far as I know. It was only after I had gone to medical school that I realized how close to death I had come in the third grade.