On Monday Night Football, Buffalo Bills safety Damar Hamlin suffered what appears to be a Sudden Cardiac Arrest (SCA) after making a tackle during the first quarter of the Bills-Bengals game. It is suspected that this SCA was caused by a rare condition known as Commotio Cordis. Hamlin was involved in a tackle and immediately stood up and then collapsed. Emergency personnel immediately attended to him by administering CPR and defibrillation with an automated external defibrillator (AED).

What is Commotio Cordis

Commotio Cordis is a sudden cardiac condition characterized by ventricular fibrillation as the result of a blunt, non-penetrating impact to the chest. It usually occurs when someone experiences an unexpected blow to the precordium region during sports activities or other types of physical contact and can cause sudden cardiac arrest and death if not treated quickly. While Commotio Cordis is relatively rare, it is a serious condition that requires immediate medical attention in order to prevent further complications or death.

Causes of Commotio Cordis

Commotio Cordis is typically caused by blunt, non-penetrating trauma to the chest wall at a precise moment in the cardiac cycle. This causes ventricular fibrillation, which disrupts the normal electrical signals responsible for maintaining an effective heartbeat. The most common cause of Commotio Cordis is a direct blow to the chest wall with a hard object, such as a baseball or hockey puck. Commotio Cordis occurs if a blunt force impact is experienced during the vulnerable period of the T-wave on an electrocardiogram (ECG). Because the impact must occur in a very small window during the T-wave it is very rare.

Symptoms of Commotio Cordis

Commotio Cordis, or sudden cardiac death, is characterized by the disruption of a normal heartbeat due to blunt, non-penetrating trauma to the chest wall. Symptoms may include loss of consciousness and collapse, along with other physical signs such as no breathing or pulse. In commotio cordis cases, these symptoms occur almost instantaneously after the trauma, occurring within just a few seconds of impact. In some cases, commotio cordis may be misdiagnosed as a heart attack arrest due to its suddenness and lack of other signs. This can delay treatment and increase the risk of death. Immediate medical assistance is essential in order to help prevent commotio cordis and potentially save a life.

Buffalo Bills Statement

The Buffalo Bills made the following statement in the early hours after the incident:

“Damar Hamlin suffered a cardiac arrest following a hit in our game versus the Bengals,” the Bills announced via a statement. “His heartbeat was restored on the field and he was transferred to the UC Medical Center for further testing and treatment. He is currently sedated and listed in critical condition.”

Sudden Cardiac Arrest

Sudden Cardiac Arrest (SCA) is a life-threatening medical condition in which the ventricles of the heart stop working normally, causing ventricular fibrillation. This can cause an individual’s heartbeat to become erratic and irregular, leading to a lack of blood flow to vital organs, including the brain. SCA can be caused by a variety of factors, including ventricular tachycardia, ventricular fibrillation, and coronary artery disease. If left untreated, SCA can lead to death within minutes. In order to restore normal heart rhythm, an automated external defibrillator (AED) is often used to deliver an electric shock that can reset the ventricles of the heart, allowing it to begin pumping correctly. Treatment with an AED is often effective in restoring normal heart rhythm and saving a person’s life.

Cardiopulmonary Resuscitation CPR

Hamlin was immediately administered Cardiopulmonary Resuscitation (CPR) which is a life-saving technique used to restore the blood circulation and breath of an individual in cardiac arrest. The procedure includes chest compressions and breaths, as well as ventilatory support such as bag valve mask ventilation, intubation, or cricothyroidotomy. CPR may be combined with the use of an AED (Automated External Defibrillator) if ventricular fibrillation is detected upon initial assessment. CPR alone may not be enough to restore the patient’s circulation, but the combination of chest compressions and ventilatory support can increase the chances of survival when performed correctly and in a timely manner. When delivered properly, CPR is an important and potentially life-saving technique.

How does an AED treat sudden cardiac arrest?

An automated external defibrillator (AED) was also used on Hamlin which is a medical device designed to treat sudden cardiac arrest (SCA). An AED works by delivering an electric shock to the heart through the chest wall in order to restore normal rhythm. The AED first analyzes the patient’s rhythm and looks for ventricular fibrillation. If ventricular fibrillation is detected, the AED provides instructions to provide an electric shock to restore normal rhythm. If ventricular fibrillation isn’t found, then the AED will not deliver a shock and appropriate medical care should be sought. An AED can be used safely by laypeople with minimal instruction and can help improve survival rates when used quickly. AEDs are an important tool in the treatment of sudden cardiac arrest and should be readily available in public places to assist those suffering from SCA.

Sudden Cardiac Arrest Can Happen to Anyone

It is important to note that sudden cardiac arrest can happen to anyone independent of their health level. Professional athletes have suffered SCA in situations other than possible commotio cordis. In 2020, Tottenham Hotspur and Danish midfielder Christian Eriksen was the victim of sudden cardiac arrest on the field and survived. Eriksen went into cardiac arrest during Denmark’s Euro 2020 opener against Finland but was revived by the use of an AED. SCA can only be treated with an AED so it is important to have an AED available in your home or business.