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Lacrosse
Published in Ira Glick, Danielle Kamis, Todd Stull, The ISSP Manual of Sports Psychiatry, 2018
Although a lesser concern for older age groups, heat-related illnesses, nutritional requirements and commotio cordis are of particular concern for youth players because of their increased risk for heat illness, and increased pliability of chest wall (Putukian et al., 2014). Heat issues become particularly relevant for youth players because of frequent tournament play in the summer months and are specifically a concern among men and goalies as protective equipment can impede heat loss. Commotio cordis is a unique medical concern to male lacrosse players, particularly at the youth level. This occurs when a non-penetrating blow to the chest leads to fatal arrhythmia, requiring immediate identification and management. Children ages 12–15 are at greatest risk (Putukian et al., 2014). Education, emergency planning, and appropriate equipment are the best ways to prevent this from occurring. Education is particularly helpful as it can help prevent risky playing behaviors such as deliberately attempting to block shots with the body.
Less Lethal Weapons, Not Including Taser
Published in Darrell L. Ross, Gary M. Vilke, Guidelines for Investigating Officer-Involved Shootings, Arrest-Related Deaths, and Deaths in Custody, 2018
Christian Sloane, Gary M. Vilke
The association of blunt projectiles and severe injuries mainly stems from risk of a direct blow to the chest, inducing a cardiac dysrhythmia such as VF. This problem has a clinical name—commotio cordis—which is a rare, but reported syndrome in which apparently young healthy individuals suddenly suffer cardiac arrest after blunt chest trauma, usually related to a sports activity such as baseball, hockey, lacrosse, and softball. Commotio cordis is characterized by a sudden disturbance of cardiac rhythm in the absence of demonstrable signs of significant mechanical injury to the heart that is induced by a direct blow to the chest. This is separate from direct injury to the heart leading to myocardial contusion, valvular disruption, or pericardial effusion. Through animal studies, researchers found that impacts that were reliably timed to that part of the cardiac cycle that occurred between 15 and 30 milliseconds preceding the peak of the electrocardiographic T wave were able to induce an irregular heartbeat known as ventricular fibrillation (VF) consistently. There is still debate, however, as to the precise pathophysiologic mechanisms at work (Zangwill & Strasburger, 2004).
Natural Deaths
Published in John M. Wayne, Cynthia A. Schandl, S. Erin Presnell, Forensic Pathology Review, 2017
John M. Wayne, Cynthia A. Schandl, S. Erin Presnell
Answer C is correct. The scenario is most compatible with cardiac stunning or concussion, termed commotio cordis. If a blow occurs at a specific time in the cardiac cycle, during the ascending phase of the T wave, arrhythmia may occur. Classically, autopsy will not identify any gross or microscopic evidence of trauma.
Developing commotio cordis injury metrics for baseball safety: unravelling the connection between chest force and rib deformation to left ventricle strain and pressure
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Grant J. Dickey, Kewei Bian, Habib R. Khan, Haojie Mao
Commotio cordis (CC) refers to sudden death from low-energy non-penetrating chest impacts over the cardiac silhouette in the absence of structural heart disease. Defined as a cardiac concussion, commotio cordis shows no signs of structural damage to the heart post-impact (Maron et al. 1995; Pearce 2005). According to the US Commotio Cordis Registry (USCCR) in Minneapolis, there are currently over 200 confirmed cases worldwide (Maron and Estes 2010; Link 2012). Although the occurrence rate of commotio cordis is low, most cases are fatal (Drewniak et al. 2007). Commotio cordis can happen in a wide variety of circumstances; ranging from casual play in a backyard or playground, to competitive hockey, lacrosse or baseball games (Kaplan et al. 1993; Maron and Estes 2010). Meanwhile, the statistics in cases are believed to be strongly influenced by the lack of awareness towards commotio cordis, suggesting that there are many more cases of the sudden death mechanism that have gone unreported (Maron and Estes 2010).