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Commonwealth Games 2002

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Wednesday, 6 March, 2002, 00:08 GMT
Death risk from freak sports injuries
heart massage
Even the young can be at risk from heart attacks
Strong blows to the chest often innocently delivered when people play sport can cause sudden cardiac death, according to research.

The majority of sports-related sudden cardiac deaths, or commotio cordis, happened while playing baseball, however, other sports which featured included ice hockey, football and lacrosse.

Non-sport related blows to the chest were also mentioned in the research and included implements such as a hollow plastic bat, a blow from the fist during "shadow" boxing and a blow to the chest from an elbow while intervening in a scuffle.


Young children with narrow and underdeveloped chest cages also appear most susceptible to commotio cordis

Dr Barry Maron
Study co-ordinator
The average age of those affected in the study was 14 and 95% were males.

The study was carried out by the Minneapolis Heart Institute Foundation and involved the study of 128 cases reported in the local Commotio Cordis Registry.

Young children susceptible

Of 128 cases, 107 individuals (84%) died as a consequence of the chest blow and 21 (16%) survived the incident.

The study's authors say commotio cordis is uncommon and "requires the exquisite confluence of several determinants such as location of the blow directly over the heart and precise timing (during a specific phase of the heart beating)".

Dr Barry Maron, who co-ordinated the study said: "Young children with narrow and underdeveloped chest cages also appear most susceptible to commotio cordis."

Chest barriers

Most commotio cordis impacts, according to the authors, are of low-energy and velocity and involve a solid core projectile such as a baseball or ice hockey puck.


The impact could trigger a cardiac abnormality, which itself causes death

Alison Cox, CRY

Only one case involved an air-filled ball, like a football, according to the study, published in The Journal of the American Medical Association.

Of the 21 who survived, 19 received resuscitation measures and two individuals recovered spontaneously.

Resuscitation was carried out on 68 victims, but only 17 (25%) survived.

Prevention

Of those playing sport when struck (79), only 22 (28%) were wearing standard, commercially available chest protection.

However, the authors state that such standard gear may not always adequately cover the chest cage especially during certain movements, leaving the chest unprotected and vulnerable.

Dr Maron said: "Our observations emphasise the dangers implicit in striking the chest sharply under any condition, including light or inadvertent blows.

"Prevention of these catastrophes will be enhanced by greater education and awareness about commotio cordis and its pathophysiology within both the lay and medical communities.

"Continued reports of these tragic events during sports emphasise the importance of more timely resuscitative efforts, including access to automated external defribilators, as well as developing preventive strategies including the design of effective chest barriers."

Alison Cox, founder and chief executive of Cardiac Risk in the Young (CRY), said the incidence of cardiac death by sudden impact in the UK were not that high.

She said: "More common is the fact that the impact could trigger a cardiac abnormality, which itself causes death.

"Impact of a ball or bat causing the heart to suddenly stop is probably more a coincidence."

See also:

29 Aug 00 | Health
Heart test could save lives
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