A minor elbow strike during a youth basketball game triggered a cardiac arrest, revealing how deadly and deceptive commotio cordis can be.
A remarkable new case report in Heart Rhythm Case Reports spotlights a dramatic medical emergency during a basketball game in Romania. An 18-year-old athlete collapsed from sudden cardiac arrest after taking a light hit to the chest—an event triggered by a rare condition called commotio cordis. What makes this case stand out is the extraordinary documentation: both ECG data and video footage confirm the diagnosis. Thanks to the fast response of bystanders who performed CPR and used a defibrillator, the young player survived.
Rising Awareness of Commotio Cordis in Sports
Commotio cordis, although rare, gained widespread attention in early 2023 when millions watched Buffalo Bills player Damar Hamlin collapse after a chest collision during an NFL game. In that case, immediate CPR and defibrillation also saved his life, underscoring the critical importance of fast action.
Just two months later, and thousands of miles away, the same life-threatening condition struck again—this time at a youth basketball tournament in Bucharest. The Romanian player, identified as M.V., was accidentally struck in the chest by an opponent’s elbow. Within seconds, he collapsed on the court. Family members and friends rushed to help, and their quick use of CPR and a defibrillator brought him back. The entire incident, captured on video, offers a rare and powerful window into how commotio cordis unfolds and how lives can be saved with prompt intervention.
Initially, there is a scramble for a loose ball and player M.V. (large white arrow) is struck in the chest by the elbow of an opponent. M.V. stumbles but remains upright for a few seconds just prior to full collapse in cardiac arrest. Credit: Heart Rhythm Case Reports
Global Incidence and Understanding of Commotio Cordis
Commotio cordis events have been reported globally in more than 20 countries, but are extraordinarily rare and virtually always counterintuitive, as in M.V.’s case. In commotio cordis, ventricular fibrillation is precipitated by a blow over the heart and requires a precise timing to a narrow 20 ms window at the upstroke of the T wave.
After the commotio cordis event, M.V. was examined at Lahey Hospital and Medical Center in Burlington, MA, USA, by a team led by Barry J. Maron, MD.
Dr. Maron explains, “There is some skepticism regarding the existence of commotio cordis. Since the case of the Romanian basketball player was recorded and documented, it validates the existence of commotio cordis. It is a real phenomenon, and it occurs in real people in sports and in daily living. It is important to raise awareness of this condition, which is reversible with prompt intervention, as this case demonstrates.”
Health and Recovery Post-Commotio Cordis
Prior to the event, M.V. was completely healthy without cardiovascular complaints; there is no family history of cardiovascular disease. When evaluated at Lahey Hospital and Medical Center six weeks after his cardiac arrest, he was asymptomatic and neurologically intact, without residual medical problems, and had begun to resume normal daily activities without difficulty.
The commotio cordis event reported here is notable for expanding the clinical spectrum of commotio cordis, given that competitive basketball previously had not been associated with this cause of cardiac arrest. Contact sports such as baseball/softball and hockey have dominated commotio cordis, owing to the greater possibility of physical contact and chest blows from hard-core projectiles (e.g., balls and pucks).
Dr. Maron concludes, “In this report, we have underscored once again that commotio cordis can occur under virtually any circumstance where there is the possibility of physical bodily contact of any magnitude, or projectile-induced chest blows, but always when least expected. This may be the best-documented case we have of commotio cordis, which should go a long way to dispel skepticism.”
Reference: “Commotio cordis…once again: Unusual occurrence in a noncontact sport” by Barry J. Maron, Ethan J. Rowin and Martin S. Maron, 13 November 2023, HeartRhythm Case Reports.
DOI: 10.1016/j.hrcr.2023.10.013
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1 Comment
Very good information.