J Korean Soc Emerg Med.  2014 Aug;25(4):484-488. 10.0000/jksem.2014.25.4.484.

Commotio Cordis by a Traffic Accident Visited the Emergency Department

• Jo UR
• Park SM
• Lee KJ
• Lee YH
• Ahn JY
• Sohn YD
• Ahn HC

• KMID: 2333907
• DOI: http://doi.org/10.0000/jksem.2014.25.4.484

Abstract

Commotio cordis is induction of sudden cardiac arrest and ventricular fibrillation (VF) by chest blunt trauma and nonpenetrating injury without damage to the rib, sternum, and heart in a person without underlying cardiovascular disease. Commotio cordis has been rarely reported worldwide, and it is particularly rare in the case of traffic accident (TA). We experienced a case of commotio cordis in a healthy 20-year-old man who was involved in a TA. The patient had no other signs of trauma except blunt chest trauma, and the initial electrocardiography (ECG) rhythm checked by the emergency medical technician (EMT) team was VF. They performed defibrillation and cardiopulmonary resuscitation (CPR) during transfer. CPR including defibrillation was performed because VF continued upon arrival at the emergency department, and therapeutic hypothermia (THT) was performed because glasgow coma scale (GCS) score was 3 after return of spontaneous circulation (ROSC). The patient's mental status became alert after performance of THT and cerebral performance category (CPC) score was 1 without neurological symptoms at the time of discharge. In trauma patients who may be have blunt chest trauma, including TA, emergency medical service providers must perform continuous monitoring with commotio cordis in mind, and perform defibrillation and CPR immediately if VF arises. With training in basic CPR and a supply of automated external defibrillators (AED) for application to trauma patients, the survival rate of commotio cordis patients can be increased.

Keyword

Commotio cordis; Ventricular fibrillation; Thoracic injuries; Nonpenetrating

MeSH Terms

Accidents, Traffic*
Cardiopulmonary Resuscitation
Cardiovascular Diseases
Commotio Cordis*
Death, Sudden, Cardiac
Defibrillators
Electrocardiography
Emergency Medical Services
Emergency Medical Technicians
Emergency Service, Hospital*
Glasgow Coma Scale
Heart
Humans
Hypothermia
Ribs
Sternum
Survival Rate
Thoracic Injuries
Thorax
Ventricular Fibrillation
Wounds, Nonpenetrating
Young Adult