Korean J Crit Care Med.  2015 Nov;30(4):349-353. 10.4266/kjccm.2015.30.4.349.

Recurrent Pulseless Ventricular Tachycardia Induced by Commotio Cordis Treated with Therapeutic Hypothermia

• Lee S
• Kang H
• Lim T
• Oh J
• Ahn C
• Lee J
• Kim C

• KMID: 2156193
• DOI: http://doi.org/10.4266/kjccm.2015.30.4.349

Abstract

The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33degrees C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.

Keyword

commotio cordis; tachycardia; therapeutic hypothermia; ventricular; thoracic injury

MeSH Terms

Adolescent
Coma
Commotio Cordis*
Emergency Service, Hospital
Female
Heart
Humans
Hypothermia*
Intensive Care Units
Memory
Survival Rate
Tachycardia
Tachycardia, Ventricular*
Thoracic Injuries
Thorax

Figure

• 

  Fig. 1. Serial findings of electrocardiography. (A) An electrocardiograph at another emergency department showed sinus tachycardia (heart rate = 107 beats/minutes) (B) Pulseless ventricular tachycardia was shown, for which a shock of 200J was immediately administered.

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  Fig. 2. Chest radiography findings. Chest radiograph on hospitalized day 1 showing diffuse opacity on both lung fields. This finding was consistent with bilateral pulmonary edema.

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  Fig. 3. The findings of brain computed tomography. Brain computed tomography on hospitalized day 2 showed an attenuation of lobar gray-white matter differentiation.

Reference

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