Football fans who tuned into the Monday Night Football game this week between the Cincinnati Bengals and Buffalo Bills were shocked when what appeared to be a routine hit on Bills safety Damar Hamlin caused his heart to stop beating.
After emergency CPR was administered Hamlin was whisked to a Cincinnati hospital where he was listed in critical condition. On Tuesday morning, millions of Americans were left to wonder, “What exactly happened, and could it happen to anyone?”
Dr. Brian Sutterer, a specialist in sports medicine, says what America witnessed on the field at Cincinnati’s Paycor Stadium is extremely rare.
“This is almost certainly something called commotio cordis, an extremely rare condition, one of those things we typically believe we are only going to read about in textbooks,” Sutterer said in a YouTube video posted late Monday night.
A blow to the chest at the wrong time
According to Sutterer, people with this condition are vulnerable if they suffer blunt-force trauma to the chest at precisely the wrong time during a heartbeat. In a heartbeat sequence, there is a small “P” wave, followed by the heartbeat, and then a small “T” wave, as the heart prepares to repeat the sequence.
“For commotio cordis to happen, you have to suffer this blunt-force trauma to the chest at exactly the right moment, specifically on the upstroke of the “T” wave in order for the heart to be sent into this arrhythmia and subsequent cardiac arrest,” Sutterer said.
According to the medical website TheHeart.org, unexpected cardiac arrest that occurs in sports is usually associated with previously diagnosed or undiagnosed structural or primary electrical cardiac abnormalities. In nearly every case these events occur in people with no underlying cardiac disease.
“There are about 30 of these cases that occur each year,” Dr. David Agus, CBS News medical expert, told the network. “They predominantly happen in kids. It happens in little league baseball, a ball is thrown by a pitcher and hits the person in the chest. It happens in soccer where something causes that blunt force trauma.”
Tips for parents of young athletes
Can commotio cordis happen to anyone? Theoretically yes, although it typically occurs in sports. However, even non-athletes might be vulnerable during an accident.
According to the Korey Stringer Institute at the University of Connecticut, the blunt-force impact doesn’t have to be that severe if it occurs at the most vulnerable moment of a heartbeat and is delivered directly over the heart.
For concerned parents of young athletes, it offers this advice:
Have an athletic trainer present at practices and games
Educate coaches, parents, and athletes how to perform CPR and use an AED
Educate coaches, parents, and athletes of signs of commotio cordis
Have an AED accessible near playing fields at all times
Ensure coaches know where to locate the AED
Ensure there is an Emergency Action Plan in place
Ensure protective equipment is properly fitted
Teach athletes how to avoid being hit with a ball/puck
Avoid strength disparities among participants and coaches
Use safety baseballs