Commotio cordis: Explaining the condition that caused Damar Hamlin to collapse on Monday Night Football

Hamlin is listed in critical condition

Getting hit in the chest isn’t something that happens often in everyday life, but during athletic activities, getting hit in the chest isn’t unusual.

Fortunately, those blows don’t usually lead to cardiac arrest, but here’s what happens when they do.

“In this particular case, we’re concerned about a very rare condition called commotio cordis, it’s very rare,” said Dr. Joshua Greenberg, a Cardiac Electrophysiologist at Henry Ford Health. “We liken it to kind of getting hit by lightning. Your chest is hit at the exact right time to cause your heart to go into an abnormally deadly heart rhythm.”

Greenberg said that rhythm is called ventricular fibrillation.

“Most commonly, it’s due to an injury where a ball, something like a lacrosse ball or a baseball, hits the chest at the right exact time,” Greenberg said.

In the department of biomedical engineering at Wayne State University, the chairperson, Dr. Cynthia Bir, studies injury biomechanics.

“It’s predominantly in the youth population,” said Dr. Bir. “We’ve seen it occur more often in children under 18 based on the data that we’ve looked at, so it’s not something that occurs very often once you get past that 18 to 20 years of age.”

One focus of WSU research is chest protection.

“We looked at a lot of different chest protectors, and sometimes they’re protective, and sometimes they’re not,” Bir said. “There’s some protectors that have been called heart guards, and they didn’t perform as well as some of the other chest protectors performed.”

Bir continued:

“I think that the chest protectors, there’s not one that’s going to necessarily prevent commotio cordis, we know that we’ve looked at it, there’s some that probably do better than others in terms of preventing that transmission of force. But the main thing that could help prevent a serious fatal outcome is having the AED close to the field.”

“If I could stress anything, it would be having people get CPR trained in the community and having these lifesaving defibrillators that can save people that have these terrible events,” Greenberg said.

While chest protectors are a good idea, at the end of the day, both experts really emphasized that awareness of the possibility of this when someone goes down after being hit in the chest and immediate access to an automated external defibrillator are the most important when it comes to commotio cordis.

Most cases of commotio cordis occur in young people with normal hearts; however, there are some cardiac problems that can increase the risk, so it is vital for young people to have good pre-sport screenings by their doctor and that might include an EKG or even an echocardiogram which is an ultrasound of the heart if indicated.

Buffalo Bills safety Damar Hamlin has been listed in critical condition.

About the Authors:

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.

Brandon Carr is a digital content producer for ClickOnDetroit and has been with WDIV Local 4 since November 2021. Brandon is the 2015 Solomon Kinloch Humanitarian award recipient for Community Service.