Sudden Cardiac Arrest from Commotio Cordis in a Competitive Hurling Athlete - Case report

Abstract

Abstract Background Commotio cordis is a rare, potentially fatal arrhythmic event precipitated by blunt trauma to the chest, typically during sports, in the absence of structural heart disease. The term, derived from Latin meaning “agitation of the heart,” reflects the mechanism in which a precisely timed impact during the vulnerable phase of ventricular repolarization induces ventricular fibrillation. Case Summary A 25-year-old male athlete with no past medical history or known cardiac conditions, and no family history of sudden cardiac death, suffered a cardiac arrest during an intermediate hurling championship match after a high-speed collision in which an opponent’s knee struck his anterior chest. Ventricular fibrillation (VF) was detected, and spontaneous circulation was restored after 1x shock. Extensive evaluation excluded structural or inherited cardiac disease. At two-year follow-up, the patient remains asymptomatic, with serial echocardiograms and has resumed competitive hurling without restrictions. Discussion Commotio Cordis occurs when blunt chest trauma, precisely timed during the upslope of the T-wave, induces ventricular fibrillation or ventricular tachycardia. Our case demonstrates classic features of commotio cordis: a previously healthy adult with no personal or family history of cardiac disease, cardiac arrest temporally related to a precordial impact, rapid restoration of circulation via AED, and favourable long term outcome.