Abstract 3960: Commercially Available Sports Equipment Do Not Protect Young Competitive Athletes Against Commotio Cordis-Related Sudden Death
Introduction. Blunt precordial blows triggering ventricular fibrillation (commotio cordis) represent a leading cause of sudden cardiac death in young athletes. Much attention has focused on the primary prevention of these tragedies with chest barriers or alterations in other sports equipment. However, an animal model of commotio cordis has demonstrated that commercially available chest protectors for youth sports do not provide adequate protection against chest blow-induced ventricular fibrillation and sudden death.
Methods. The National Commotio Cordis Registry (Minneapolis, MN) was accessed to determine the likelihood of sudden death in athletes exposed to precordial blows while wearing chest protectors.
Results. Of the 182 commotio cordis registry cases, 85 (47%) occurred during practice or competition in organized sports. In 33 of these 85 competitive athletes (39%), fatal chest blow events occurred despite the presence of potentially protective equipment. The athletes wore standard, commercially-available chest barriers, made of polymer foam covered by fabric or hard shell, generally perceived as providing protection from the arrhythmic consequences of chest blows. These included the following sports: hockey (n = 14; with 2 goalies), football (n = 10), lacrosse (n = 6; including 3 goalies), and baseball (n = 3; all catchers). Scenarios included:
failure of the padding to cover the precordium at the time of the blows so that projectiles (such as baseballs and hockey pucks) or sticks and body checks, appeared to circumvent the protective barrier (n = 23); or
projectiles directly striking the chest barrier (n = 10).
Conclusions. A significant proportion (i.e., about 40%) of the sudden deaths reported in young competitive athletes due to blunt chest blows (commotio cordis) occur despite the presence of commercially available sports equipment perceived as potentially protective. These findings suggest the necessity for greater attention directed toward chest protection to make the athletic field safer for youth sports participants.