898:
703:
168:
66:
25:
258:
941:
908:(AED) and prompt CPR helped to increase the survival rate to 58 percent. CPR and defibrillation must be started urgently (within three minutes) to avoid death of the person impacted. To assure life-saving procedures and equipment are in place at events where impact injuries are possible, clinical recommendations state that "communities and
450:—the survival rate was forty percent if resuscitation was performed within three minutes of the impact injury, contrasted with only five percent survival if resuscitation was delayed to more than three minutes after the impact. During the early 21st century, survival rates continued to improve to 58 percent of cases.
865:
The risk of impact may be reduced by improved coaching techniques, such as teaching young batters to turn away from the ball to avoid errant pitches in baseball. Defensive players in lacrosse and hockey may be coached to avoid using their chest to block the ball or puck. Starting in 2017, high school
869:
Chest protectors and vests are designed to reduce trauma from blunt bodily injury, but many commercially available chest protectors do not offer protection from commotio cordis and may offer a false sense of security. A 2010 study found that almost 20 percent of the victims in competitive football,
836:
in the heart's electrical activity, which in some cases, if occurring right at the trailing edge of a previous electrical cycle, can induce ventricular fibrillation, also known as stretch-induced VF. Since the trailing edge of the preceding electrical cycle travels over the ventricular surface, the
442:
to vital organs, commotio cordis has a high fatality rate, indicated by two studies to be 72–75 percent, with survival decreasing substantially if effective resuscitation was not performed within three minutes of the impact event. In a United States timeline analysis, survival was only ten percent
421:
There are only 10–20 cases annually in the United States. These cases occur mostly in boys and young men (mean age 15), usually during sports participation. It occurs most frequently in baseball when the hard ball strikes an unprotected chest, although there have been cases of commotio cordis in
621:
The velocity of the impact by a hard object is a critical factor for the onset of commotio cordis: impacts at 40 miles per hour (64 kilometres per hour) were the most likely to cause ventricular fibrillation in an animal model. At velocities of 20 miles per hour (32 km/h), ventricular
694:. It has been discussed controversially, as—in particular in severe hypoxia—it may cause the opposite effect (i.e., a worsening of rhythm—commotio cordis). In a normal adult, the energy range involved in the precordial thump is five to ten times below that associated with commotio cordis.
827:
mechanisms of commotio cordis are not fully understood. However, it is widely recognized that it may be related to the mechanical impact, or stretch, on the myocardial tissue cell membranes. This impact is believed to activate the stretch-activated, pressure–sensitive proteins called
853:
balls may reduce the impact trauma causing commotio cordis. The shape of the impact object may be modified for some conditions, such as by using a flat object – which did not induce ventricular fibrillation upon impact in preliminary research – whereas spherical objects with smaller
920:
Several people have been charged and convicted for the deaths of victims of commotio cordis, even when the blows rendered were never given with an intent to kill. In 1992, Italian hockey player Miran
Schrott died after a blow to his chest from the stick of Italian-Canadian player
690:(hard blows given over the precordium with a closed fist to revert cardiac arrest) is a sanctioned procedure for emergency resuscitation by trained health professionals witnessing a monitored arrest when no equipment is at hand, endorsed by the latest guidelines of the
422:
players using a chest protector. It is usually caused by a projectile, but can also be caused by a blow from another player's elbow or other body part. Being less developed, the thorax of an adolescent is likely more prone to this injury than a mature adult.
618:, where there is no overlying lung tissue, were the most likely to cause ventricular fibrillation. Impacts not over the heart did not cause ventricular fibrillation. Ventricular fibrillation was more easily induced in smaller, leaner animals.
728:(ms) before the peak of the T wave to the instant of the actual peak) will cause the ventricular fibrillation of commotio cordis, with an increased probability occurring when an impact happens from 30 to 10 ms before the peak of the T wave.
566:
struck his chest. Pronger went into cardiac arrest and was unconscious for 20 seconds while he was resuscitated by members of both the Blues' and Red Wings' training staff. Pronger made a full recovery after an overnight stay at
425:
Over a period of assessment from 2006–2012, the survival rate was 58 percent, which was an improvement over the years 1993–2006 when only 34 percent of victims survived. This increase is likely due to prompt CPR, access to
1667:
1934:
575:
and would be cleared to play again four days later. The incident ultimately had a negligible effect on his career, which lasted until 2011. Another high-profile incident occurred on
January 3, 2023, during
265:
Human adult thorax, showing the outline of the heart in red. The sensitive zone for mechanical induction of heart rhythm disturbances lies between the second and the fourth ribs, to the left of the sternum.
1479:"Mechanically Induced Ectopy via Stretch-Activated Cation-Nonselective Channels Is Caused by Local Tissue Deformation and Results in Ventricular Fibrillation if Triggered on the Repolarization Wave Edge (
392:, complete disorganization of the heart's pumping function, and cardiac arrest. It is not caused by mechanical damage to the heart muscle or surrounding organs and is not the result of heart disease.
534:. Commotio cordis may occur in other sports via impacts to the chest by elbows or heads. It has also been reported outside of sports when there is sudden impact to the chest wall by hard objects or
870:
baseball, lacrosse, and hockey were wearing protectors. A 2017 study found that specially-designed chest protectors do reduce the risk of commotio cordis, but do not offer 100 percent protection.
602:'s helmet struck him in the chest as he was making a tackle. Hamlin collapsed and went into cardiac arrest, and his life was saved by the Bills' training staff administering CPR and employing an
795:
1289:
885:
made chest protectors that meet the NOCSAE ND200 standard a requirement for all goalies, and expanded coverage in 2022 to require all players to wear such a chest protector. In 2018, the
395:
Its incidence in the United States is fewer than 20 cases per year, often occurring in boys participating in sports, most commonly in baseball when a ball strikes a player in the chest.
816:
The small window of vulnerability in the cardiac electrical cycle explains why it is a rare event. Considering that the total cardiac cycle has a duration of one second (for a base
874:
443:
over the years 1970–1993, while during 1994–2012, survival improved to 34 percent. A 2009 paper reported that survival drops to 3% when resuscitation is delayed beyond 3 minutes.
1162:
Maron, Barry J.; Haas, Tammy S.; Ahluwalia, Aneesha; Garberich, Ross F.; Estes, N. A. Mark; Link, Mark S. (February 2013). "Increasing survival rate from commotio cordis".
866:
lacrosse players are penalized, and play is stopped immediately if they enter their own goal crease with the apparent intent of blocking shots or acting as goalkeeper.
1668:"NOCSAE Finalizes First-Ever Football Helmet Standard to Address Concussion Risks from Rotational Forces and First Chest Protector Standard for Commotio Cordis"
519:. Almost all (96%) of the victims were male, the mean age of the victims during that period was 14.7 years, and fewer than one in five survived the incident.
1604:
886:
671:, and frontal collisions of motor vehicles (the impact of the steering wheel against the thorax, although this has decreased substantially with the use of
858:
were more likely to induce ventricular fibrillation. Safety baseballs having lower degrees of hardness, e.g., softer, pliable and elastic balls used for
1405:
1745:"Efficacy of bystander cardiopulmonary resuscitation and out-of-hospital automated external defibrillation as life-saving therapy in commotio cordis"
651:
1297:
717:
The deviation of commotio cordis from the normal electrical rhythm of the heart is assessed scientifically in laboratory studies by analysis of the
691:
649:
of the heart, involving possible rupture of a heart chamber or damage to a heart valve as may occur in a violent vehicle accident, may be called
1379:
800:
Impact occurring within a specific 10- to 30-ms portion of the cardiac cycle. This period occurs in the ascending phase of the T wave when the
614:
In experimental animal models in pigs studying impacts by a hard ball to the chest wall, impacts that occurred directly over the center of the
178:
879:
Standard Test Method and
Performance Specification Used in Evaluating the Performance Characteristics of Chest Protectors for Commotio Cordis
2014:
384:. The condition is 97% fatal if not treated within three minutes. This sudden rise in intracavitary pressure leads to disruption of normal
522:
Baseball is the most common sport in which commotio cordis occurs in regions where it is played, particularly among teenage boys who are
877:
finalized a new standard outlining performance requirements and test methods for chest protectors used in baseball and lacrosse, ND200
2211:
889:
changed their baseball rules to require the catcher to wear a chest protector that meets the NOCSAE ND200 standard requirements.
1346:
2042:
1693:
912:
reexamine the need for accessible automatic defibrillators and CPR-trained coaches at organized sporting events for children."
515:. From 1996 to spring 2007, the US National Commotio Cordis Registry had 188 cases recorded, with about half occurring during
130:
1820:
102:
1620:"Development of a Chest Wall Protector Effective in Preventing Sudden Cardiac Death by Chest Wall Impact (Commotio Cordis)"
586:
745:
109:
929:, and eventually pleaded guilty to manslaughter, paying a $ 1,300 fine and $ 175,000 restitution to Schrott's family.
230:
212:
149:
52:
1205:
Abrunzo TJ (November 1991). "Commotio cordis. The single, most common cause of traumatic death in youth baseball".
905:
603:
464:
447:
410:
83:
38:
820:
of 60 beats per minute), the probability of impact trauma within the window of vulnerability is 1–3 percent only.
116:
724:(see ECG image). Only chest impacts occurring on a narrow band of the ECG during the upslope of the T wave (40
87:
1044:"Commotio Cordis: Ventricular Fibrillation Triggered by Chest Impact–Induced Abnormalities in Repolarization"
406:
335:
1718:
667:
Commotio cordis may also occur in other situations, such as in children who are physically abused, cases of
413:
is employed within three minutes of the impact, survival from commotio cordis can be as high as 58 percent.
98:
463:
Commotio cordis is a very rare event, but nonetheless it is often considered when an athlete presents with
1882:
Geddes LA, Roeder RA (January 2005). "Evolution of our knowledge of sudden death due to commotio cordis".
837:
critical window for mechanical induction of ventricular fibrillation varies locally across the ventricle.
2196:
1449:
637:
of an adult. The 50-joule threshold, however, can be considerably lower when the victim's heart is under
2035:
1540:"Cardiac Mechano-Electric Coupling: Acute Effects of Mechanical Stimulation on Heart Rate and Rhythm"
551:
385:
2206:
2201:
2080:
1949:
389:
287:
194:
1784:
Maron BJ, Mitten MJ, Greene
Burnett C (January 2002). "Criminal consequences of commotio cordis".
1320:
2165:
2131:
282:
76:
500:
2191:
2170:
2085:
2028:
578:
123:
2160:
2100:
190:
44:
511:). Children are especially vulnerable, possibly due to the mechanical properties of their
446:
Higher survival rates correlated with immediate resuscitation by using CPR and an on-site
8:
2155:
2004:
1218:
959:
718:
710:
during which commotio cordis is a risk if a severe chest impact occurs within the narrow
630:
568:
186:
862:
or more pliable baseballs for older age groups, may reduce the risk of commotio cordis.
2119:
2065:
1644:
1619:
1577:
1515:
1478:
1230:
1122:
1089:
805:
593:
1865:
1848:
1797:
2109:
1960:
1899:
1870:
1801:
1766:
1649:
1581:
1569:
1561:
1520:
1502:
1354:
1268:
1222:
1187:
1179:
1127:
1109:
1065:
964:
954:
926:
555:
523:
468:
324:
270:
2020:
1234:
2150:
1989:
1891:
1860:
1793:
1756:
1639:
1631:
1551:
1510:
1494:
1260:
1214:
1171:
1117:
1101:
1055:
687:
2114:
1954:
1635:
946:
909:
642:
541:
516:
1761:
1744:
1406:"What is commotio cordis, which NFL player Damar Hamlin says stopped his heart?"
1347:"'We're Going to Need Everybody': Recordings Captured Response to N.F.L. Crisis"
1175:
845:
For some sports participation in which hard balls are used, such as baseball or
1965:
1895:
1556:
1539:
969:
833:
824:
801:
739:
615:
563:
508:
480:
439:
427:
339:
1618:
Kumar, Kartik; Mandleywala, Swati N.; Gannon, Michael P.; et al. (2017).
1498:
1450:"Fitness Blogger Rebecca Burger Died After a Whipped Cream Dispenser Exploded"
1060:
1043:
633:) may cause cardiac arrest when applied at the right time and location of the
467:. Some of the sports which have a risk for this cause of trauma are baseball,
398:
Commotio cordis can occur only upon impact within a narrow window of about 40
2185:
2055:
1565:
1506:
1358:
1183:
1113:
1105:
897:
680:
596:
583:
547:
488:
381:
1943:
1849:"Sudden cardiac death by Commotio cordis: role of mechano-electric feedback"
1477:
Quinn, T. Alexander; Jin, Honghua; Lee, Peter; Kohl, Peter (9 August 2017).
702:
2140:
2051:
1903:
1874:
1805:
1770:
1653:
1600:
1573:
1524:
1272:
1191:
1131:
1069:
882:
829:
707:
679:). In one fatality, the impact to the chest was the result of an exploding
589:
376:
that occurs as a result of a blow to the area directly over the heart (the
373:
1436:
Cardiac
Mechano-Electric Feedback and Arrhythmias: from Pipette to Patient
1264:
1226:
2095:
1293:
875:
National
Operating Committee on Standards for Athletic Equipment (NOCSAE)
725:
672:
599:
399:
319:
1926:
2145:
817:
735:
Direction of impact over the precordium (precise area, angle of impact)
634:
544:
472:
377:
307:
275:
90: in this section. Unsourced material may be challenged and removed.
2008:
1984:
346:
1743:
Salib EA, Cyran SE, Cilley RE, Maron BJ, Thomas NJ (December 2005).
257:
65:
2075:
1694:"Heart to Heart: NOCSAE, USL Work to Reduce Risk of Commtio Cordis"
922:
859:
846:
809:
659:
for "bruising of the heart"), but is unrelated to commotio cordis.
638:
559:
492:
372:, "agitation or disruption of the heart") is a rare disruption of
351:
Survival rate drops to <5% if not resuscitated within 3 minutes
850:
676:
668:
572:
531:
527:
504:
484:
1938:
1617:
855:
721:
646:
512:
496:
438:
Due to ventricular fibrillation and resultant cessation of the
402:
in the cardiac electrical cycle, explaining why it is so rare.
311:
290:, quickly followed by cardiac arrest and (if not treated) death
738:
Total applied energy (area of impact versus energy, i.e., the
656:
626:
369:
887:
National
Federation of State High School Associations (NFHS)
1345:
Belson, Ken; Blinder, Alan; Stein, Robin (5 January 2023).
1161:
535:
476:
1783:
1588:
763:
731:
These factors influence the onset of commotio cordis:
327:
can reduce amount of impact energy required to trigger
310:
between 10 and 40 milliseconds before the peak of the
2050:
1742:
1605:
National
Federation of State High School Associations
748:
1916:
1846:
1251:
Maron BJ, Estes NA (March 2010). "Commotio cordis".
936:
1538:Quinn, T. Alexander; Kohl, Peter (1 January 2021).
1380:"Bills say Hamlin suffered cardiac arrest in game"
1344:
790:{\displaystyle E_{\text{k}}={\tfrac {1}{2}}mv^{2}}
789:
430:, and higher public awareness of this phenomenon.
1847:Kohl P, Nesbitt AD, Cooper PJ, Lei M (May 2001).
2183:
692:International Liaison Committee on Resuscitation
1476:
1088:Palacio, Luis E.; Link, Mark S. (March 2009).
2036:
1487:Circulation: Arrhythmia and Electrophysiology
1048:Circulation: Arrhythmia and Electrophysiology
433:
175:The examples and perspective in this article
1881:
1430:
1428:
1426:
1094:Sports Health: A Multidisciplinary Approach
1087:
53:Learn how and when to remove these messages
2043:
2029:
1884:The American Journal of Emergency Medicine
1611:
1284:
1282:
1250:
832:. Changes in ion channels lead to altered
706:Electrocardiograph: the portion of normal
256:
1864:
1760:
1643:
1555:
1537:
1514:
1438:. Elsevier (Saunders), Philadelphia 2005.
1121:
1083:
1081:
1079:
1059:
231:Learn how and when to remove this message
213:Learn how and when to remove this message
150:Learn how and when to remove this message
1472:
1470:
1423:
1207:American Journal of Diseases of Children
896:
701:
1318:
1290:"Position Statement on Commotio Cordis"
1279:
1246:
1244:
1204:
1037:
1035:
1033:
1031:
1029:
1027:
1025:
1023:
1021:
1019:
1017:
1015:
1013:
1011:
1009:
1007:
1005:
2184:
1076:
1003:
1001:
999:
997:
995:
993:
991:
989:
987:
985:
409:(CPR) combined with use of an on-site
16:Disruption of heart rhythm from a blow
2024:
1821:"Darcy Robinson's death brings shock"
1467:
1434:Kohl P, Sachs F & Franz M (eds):
1818:
1241:
1219:10.1001/archpedi.1991.02160110071023
1157:
1155:
1153:
1151:
1149:
1147:
1145:
1143:
1141:
1041:
161:
88:adding citations to reliable sources
59:
18:
1253:The New England Journal of Medicine
982:
662:
550:experienced commotio cordis during
13:
1839:
1786:The American Journal of Cardiology
1624:Clinical Journal of Sport Medicine
1447:
592:experienced commotio cordis after
14:
2223:
2015:National Commotio Cordis Registry
1912:
1819:Maki, Allan (28 September 2007).
1321:"Outtakes: Chris Pronger (uncut)"
1138:
906:Automated external defibrillators
840:
609:
471:, association football (soccer),
34:This article has multiple issues.
939:
604:automated external defibrillator
448:automated external defibrillator
411:automated external defibrillator
314:portion of normal cardiac rhythm
166:
64:
23:
2212:Latin medical words and phrases
1812:
1777:
1736:
1719:"Baseball Rules Changes - 2018"
1711:
1686:
1660:
1531:
1441:
1398:
915:
625:Impact energies of at least 50
380:) at a critical instant during
75:needs additional citations for
42:or discuss these issues on the
1372:
1338:
1319:Patrick, Dan (19 March 2001).
1312:
1296:. January 2008. Archived from
1198:
1042:Link, Mark S. (1 April 2012).
552:a playoff game on May 11, 1998
1:
1866:10.1016/S0008-6363(01)00194-8
1798:10.1016/S0002-9149(01)02202-0
1597:2018 Boys' Lacrosse Rule Book
975:
804:is repolarizing, moving from
416:
407:cardiopulmonary resuscitation
1636:10.1097/JSM.0000000000000297
892:
697:
622:fibrillation did not occur.
526:or playing the positions of
7:
1762:10.1016/j.jpeds.2005.07.041
1176:10.1016/j.hrthm.2012.10.034
932:
298:Within seconds after impact
189:, discuss the issue on the
10:
2228:
1896:10.1016/j.ajem.2003.12.023
1557:10.1152/physrev.00036.2019
901:Defibrillator training kit
434:Potential for sudden death
2128:
2062:
1975:
1920:
1749:The Journal of Pediatrics
1499:10.1161/CIRCEP.116.004777
1061:10.1161/CIRCEP.111.962712
458:
453:
386:heart electrical activity
355:
345:
331:
318:
302:
294:
281:
269:
264:
255:
250:
2081:Traumatic aortic rupture
1106:10.1177/1941738108330972
925:. Boni was charged with
719:electrocardiograph (ECG)
390:ventricular fibrillation
388:, followed instantly by
382:the cycle of a heartbeat
288:Ventricular fibrillation
2166:Tracheobronchial injury
2132:lower respiratory tract
1853:Cardiovascular Research
641:conditions, such as in
306:Sufficient blow to the
902:
881:. Beginning in 2021,
791:
714:
507:and martial arts (see
501:professional wrestling
2171:Diaphragmatic rupture
2086:Thoracic aorta injury
1544:Physiological Reviews
1265:10.1056/NEJMra0910111
900:
792:
705:
579:Monday Night Football
2161:Pulmonary laceration
2101:Myocardial contusion
1823:. The Globe and Mail
746:
712:vulnerability window
465:sudden cardiac death
195:create a new article
187:improve this article
177:may not represent a
84:improve this article
2156:Pulmonary contusion
1607:. 2018. p. 47.
1300:on 23 February 2017
960:Pulmonary contusion
569:Henry Ford Hospital
2197:Cardiac arrhythmia
2120:Myocardial rupture
2066:circulatory system
1976:External resources
1351:The New York Times
903:
787:
772:
742:of the projectile
715:
594:Cincinnati Bengals
2179:
2178:
2110:Cardiac tamponade
2011:, September 2005.
1999:
1998:
1674:. 30 January 2017
1213:(11): 1279–1282.
1090:"Commotio Cordis"
965:R-on-T phenomenon
955:Commotio thoracis
927:culpable homicide
771:
756:
686:In contrast, the
631:foot-pounds force
556:Detroit Red Wings
513:thoracic skeleton
469:American football
378:precordial region
363:
362:
325:Coronary ischemia
245:Medical condition
241:
240:
233:
223:
222:
215:
197:, as appropriate.
160:
159:
152:
134:
99:"Commotio cordis"
57:
2219:
2151:Hemopneumothorax
2045:
2038:
2031:
2022:
2021:
1918:
1917:
1907:
1878:
1868:
1833:
1832:
1830:
1828:
1816:
1810:
1809:
1781:
1775:
1774:
1764:
1740:
1734:
1733:
1731:
1729:
1715:
1709:
1708:
1706:
1704:
1690:
1684:
1683:
1681:
1679:
1664:
1658:
1657:
1647:
1615:
1609:
1608:
1592:
1586:
1585:
1559:
1535:
1529:
1528:
1518:
1474:
1465:
1464:
1462:
1460:
1445:
1439:
1432:
1421:
1420:
1418:
1416:
1402:
1396:
1395:
1393:
1391:
1386:. 3 January 2023
1376:
1370:
1369:
1367:
1365:
1342:
1336:
1335:
1333:
1331:
1316:
1310:
1309:
1307:
1305:
1286:
1277:
1276:
1248:
1239:
1238:
1202:
1196:
1195:
1159:
1136:
1135:
1125:
1085:
1074:
1073:
1063:
1039:
949:
944:
943:
942:
910:school districts
796:
794:
793:
788:
786:
785:
773:
764:
758:
757:
754:
688:precordial thump
663:Other situations
517:organized sports
260:
248:
247:
236:
229:
218:
211:
207:
204:
198:
170:
169:
162:
155:
148:
144:
141:
135:
133:
92:
68:
60:
49:
27:
26:
19:
2227:
2226:
2222:
2221:
2220:
2218:
2217:
2216:
2202:Sports medicine
2182:
2181:
2180:
2175:
2130:
2124:
2115:Hemopericardium
2105:Commotio cordis
2064:
2058:
2049:
2005:Commotio cordis
2000:
1995:
1994:
1971:
1970:
1929:
1915:
1910:
1842:
1840:Further reading
1837:
1836:
1826:
1824:
1817:
1813:
1782:
1778:
1741:
1737:
1727:
1725:
1717:
1716:
1712:
1702:
1700:
1692:
1691:
1687:
1677:
1675:
1666:
1665:
1661:
1616:
1612:
1595:
1593:
1589:
1536:
1532:
1481:Commotio Cordis
1475:
1468:
1458:
1456:
1448:Barnes, Zahra.
1446:
1442:
1433:
1424:
1414:
1412:
1404:
1403:
1399:
1389:
1387:
1378:
1377:
1373:
1363:
1361:
1343:
1339:
1329:
1327:
1317:
1313:
1303:
1301:
1288:
1287:
1280:
1259:(10): 917–927.
1249:
1242:
1203:
1199:
1160:
1139:
1086:
1077:
1040:
983:
978:
947:Medicine portal
945:
940:
938:
935:
918:
895:
849:, softer, more
843:
781:
777:
762:
753:
749:
747:
744:
743:
700:
665:
652:contusio cordis
645:insufficiency.
643:coronary artery
612:
542:St. Louis Blues
461:
456:
436:
419:
366:Commotio cordis
251:Commotio cordis
246:
237:
226:
225:
224:
219:
208:
202:
199:
184:
171:
167:
156:
145:
139:
136:
93:
91:
81:
69:
28:
24:
17:
12:
11:
5:
2225:
2215:
2214:
2209:
2204:
2199:
2194:
2177:
2176:
2174:
2173:
2168:
2163:
2158:
2153:
2148:
2143:
2137:
2135:
2126:
2125:
2123:
2122:
2117:
2112:
2107:
2091:
2090:
2089:
2088:
2071:
2069:
2060:
2059:
2048:
2047:
2040:
2033:
2025:
2019:
2018:
2012:
1997:
1996:
1993:
1992:
1980:
1979:
1977:
1973:
1972:
1969:
1968:
1957:
1946:
1930:
1925:
1924:
1922:
1921:Classification
1914:
1913:External links
1911:
1909:
1908:
1879:
1859:(2): 280–289.
1843:
1841:
1838:
1835:
1834:
1811:
1792:(2): 210–213.
1776:
1755:(6): 863–866.
1735:
1710:
1685:
1659:
1610:
1587:
1530:
1493:(8): e004777.
1466:
1440:
1422:
1397:
1371:
1337:
1311:
1278:
1240:
1197:
1170:(2): 219–223.
1137:
1100:(2): 174–179.
1075:
1054:(2): 425–432.
980:
979:
977:
974:
973:
972:
970:Touch of Death
967:
962:
957:
951:
950:
934:
931:
917:
914:
894:
891:
842:
841:Risk reduction
839:
834:repolarization
814:
813:
802:left ventricle
798:
784:
780:
776:
770:
767:
761:
752:
740:kinetic energy
736:
699:
696:
664:
661:
616:left ventricle
611:
610:Impact factors
608:
564:Dmitri Mironov
509:Touch of Death
481:rugby football
460:
457:
455:
452:
440:cardiac output
435:
432:
428:defibrillation
418:
415:
361:
360:
359:Extremely rare
357:
353:
352:
349:
343:
342:
340:defibrillation
333:
329:
328:
322:
316:
315:
304:
300:
299:
296:
292:
291:
285:
279:
278:
273:
267:
266:
262:
261:
253:
252:
244:
239:
238:
221:
220:
181:of the subject
179:worldwide view
174:
172:
165:
158:
157:
72:
70:
63:
58:
32:
31:
29:
22:
15:
9:
6:
4:
3:
2:
2224:
2213:
2210:
2208:
2205:
2203:
2200:
2198:
2195:
2193:
2190:
2189:
2187:
2172:
2169:
2167:
2164:
2162:
2159:
2157:
2154:
2152:
2149:
2147:
2144:
2142:
2139:
2138:
2136:
2133:
2127:
2121:
2118:
2116:
2113:
2111:
2108:
2106:
2102:
2099:
2097:
2093:
2092:
2087:
2084:
2083:
2082:
2079:
2077:
2073:
2072:
2070:
2067:
2061:
2057:
2053:
2046:
2041:
2039:
2034:
2032:
2027:
2026:
2023:
2016:
2013:
2010:
2006:
2002:
2001:
1991:
1987:
1986:
1982:
1981:
1978:
1974:
1967:
1963:
1962:
1958:
1956:
1952:
1951:
1947:
1945:
1941:
1940:
1936:
1932:
1931:
1928:
1923:
1919:
1905:
1901:
1897:
1893:
1889:
1885:
1880:
1876:
1872:
1867:
1862:
1858:
1854:
1850:
1845:
1844:
1822:
1815:
1807:
1803:
1799:
1795:
1791:
1787:
1780:
1772:
1768:
1763:
1758:
1754:
1750:
1746:
1739:
1724:
1720:
1714:
1699:
1695:
1689:
1673:
1669:
1663:
1655:
1651:
1646:
1641:
1637:
1633:
1629:
1625:
1621:
1614:
1606:
1602:
1598:
1594:Rule 4.18.4,
1591:
1583:
1579:
1575:
1571:
1567:
1563:
1558:
1553:
1549:
1545:
1541:
1534:
1526:
1522:
1517:
1512:
1508:
1504:
1500:
1496:
1492:
1488:
1484:
1482:
1473:
1471:
1455:
1451:
1444:
1437:
1431:
1429:
1427:
1411:
1410:www.heart.org
1407:
1401:
1385:
1381:
1375:
1360:
1356:
1352:
1348:
1341:
1326:
1322:
1315:
1299:
1295:
1291:
1285:
1283:
1274:
1270:
1266:
1262:
1258:
1254:
1247:
1245:
1236:
1232:
1228:
1224:
1220:
1216:
1212:
1208:
1201:
1193:
1189:
1185:
1181:
1177:
1173:
1169:
1165:
1158:
1156:
1154:
1152:
1150:
1148:
1146:
1144:
1142:
1133:
1129:
1124:
1119:
1115:
1111:
1107:
1103:
1099:
1095:
1091:
1084:
1082:
1080:
1071:
1067:
1062:
1057:
1053:
1049:
1045:
1038:
1036:
1034:
1032:
1030:
1028:
1026:
1024:
1022:
1020:
1018:
1016:
1014:
1012:
1010:
1008:
1006:
1004:
1002:
1000:
998:
996:
994:
992:
990:
988:
986:
981:
971:
968:
966:
963:
961:
958:
956:
953:
952:
948:
937:
930:
928:
924:
913:
911:
907:
899:
890:
888:
884:
880:
876:
873:In 2017, the
871:
867:
863:
861:
857:
852:
848:
838:
835:
831:
826:
821:
819:
812:(relaxation).
811:
807:
803:
799:
782:
778:
774:
768:
765:
759:
750:
741:
737:
734:
733:
732:
729:
727:
723:
720:
713:
709:
704:
695:
693:
689:
684:
682:
681:whipped cream
678:
674:
670:
660:
658:
654:
653:
648:
644:
640:
636:
632:
628:
623:
619:
617:
607:
605:
601:
598:
597:wide receiver
595:
591:
588:
585:
584:Buffalo Bills
581:
580:
574:
570:
565:
561:
557:
553:
549:
548:Chris Pronger
546:
543:
539:
537:
533:
529:
525:
520:
518:
514:
510:
506:
502:
498:
494:
490:
486:
482:
478:
474:
470:
466:
451:
449:
444:
441:
431:
429:
423:
414:
412:
408:
403:
401:
396:
393:
391:
387:
383:
379:
375:
371:
367:
358:
354:
350:
348:
344:
341:
337:
334:
330:
326:
323:
321:
317:
313:
309:
305:
301:
297:
293:
289:
286:
284:
283:Complications
280:
277:
274:
272:
268:
263:
259:
254:
249:
243:
235:
232:
217:
214:
206:
196:
192:
188:
182:
180:
173:
164:
163:
154:
151:
143:
132:
129:
125:
122:
118:
115:
111:
108:
104:
101: –
100:
96:
95:Find sources:
89:
85:
79:
78:
73:This section
71:
67:
62:
61:
56:
54:
47:
46:
41:
40:
35:
30:
21:
20:
2207:Men's health
2192:Chest trauma
2141:Pneumothorax
2104:
2094:
2074:
2054:, excluding
2052:Chest injury
2003:Yabek, S.M.
1983:
1959:
1948:
1933:
1890:(1): 67–75.
1887:
1883:
1856:
1852:
1825:. Retrieved
1814:
1789:
1785:
1779:
1752:
1748:
1738:
1726:. Retrieved
1722:
1713:
1701:. Retrieved
1698:USA Lacrosse
1697:
1688:
1676:. Retrieved
1671:
1662:
1630:(1): 26–30.
1627:
1623:
1613:
1601:Indianapolis
1596:
1590:
1550:(1): 37–92.
1547:
1543:
1533:
1490:
1486:
1480:
1457:. Retrieved
1453:
1443:
1435:
1413:. Retrieved
1409:
1400:
1388:. Retrieved
1383:
1374:
1362:. Retrieved
1350:
1340:
1328:. Retrieved
1324:
1314:
1302:. Retrieved
1298:the original
1256:
1252:
1210:
1206:
1200:
1167:
1164:Heart Rhythm
1163:
1097:
1093:
1051:
1047:
919:
916:Legal issues
904:
878:
872:
868:
864:
844:
830:ion channels
822:
815:
730:
726:milliseconds
716:
711:
708:sinus rhythm
685:
673:safety belts
666:
650:
624:
620:
613:
590:Damar Hamlin
577:
554:against the
540:
521:
487:, softball,
462:
445:
437:
424:
420:
404:
400:milliseconds
397:
394:
374:heart rhythm
365:
364:
320:Risk factors
242:
227:
209:
200:
176:
146:
140:January 2023
137:
127:
120:
113:
106:
94:
82:Please help
77:verification
74:
50:
43:
37:
36:Please help
33:
2063:Cardiac and
1827:29 February
1603:, Indiana:
1304:22 February
1294:US Lacrosse
883:US Lacrosse
600:Tee Higgins
295:Usual onset
2186:Categories
2146:Hemothorax
1961:DiseasesDB
976:References
923:Jimmy Boni
818:heart rate
683:canister.
635:precordium
545:defenceman
473:ice hockey
417:Assessment
308:precordium
276:Cardiology
110:newspapers
39:improve it
2056:fractures
2009:eMedicine
1985:eMedicine
1582:218554597
1566:0031-9333
1507:1941-3149
1364:6 January
1359:0362-4331
1330:6 January
1184:1556-3871
1114:1941-7381
893:Treatment
698:Mechanism
647:Contusion
356:Frequency
347:Prognosis
332:Treatment
271:Specialty
203:July 2024
191:talk page
45:talk page
2134:injuries
2129:Lung and
2076:vascular
2068:injuries
1990:ped/3019
1904:15672341
1875:11334832
1806:11792344
1771:16356450
1654:27014942
1574:32380895
1525:28794084
1384:ESPN.com
1273:20220186
1235:31217442
1192:23107651
1132:23015869
1070:22511659
933:See also
860:Tee-ball
847:lacrosse
825:cellular
810:diastole
677:air bags
639:ischemic
560:slapshot
493:lacrosse
185:You may
1955:D056104
1728:1 April
1703:1 April
1678:1 April
1645:5181132
1516:5555388
1459:14 July
1227:1951221
1123:3445066
851:pliable
806:systole
669:torture
606:(AED).
573:Detroit
558:when a
532:catcher
528:pitcher
524:batting
505:hurling
485:cricket
124:scholar
1902:
1873:
1804:
1769:
1672:NOCSAE
1652:
1642:
1580:
1572:
1564:
1523:
1513:
1505:
1357:
1271:
1233:
1225:
1190:
1182:
1130:
1120:
1112:
1068:
722:T wave
655:(from
627:joules
587:safety
497:boxing
489:pelota
459:Sports
454:Causes
312:T wave
303:Causes
126:
119:
112:
105:
97:
2096:heart
1966:35055
1578:S2CID
1415:9 May
1390:9 May
1231:S2CID
856:radii
657:Latin
582:when
562:from
536:fists
370:Latin
193:, or
131:JSTOR
117:books
2017:(US)
1950:MeSH
1900:PMID
1871:PMID
1829:2016
1802:PMID
1767:PMID
1730:2024
1723:NFHS
1705:2024
1680:2024
1650:PMID
1570:PMID
1562:ISSN
1521:PMID
1503:ISSN
1461:2017
1454:SELF
1417:2023
1392:2023
1366:2023
1355:ISSN
1332:2023
1325:ESPN
1306:2017
1269:PMID
1223:PMID
1188:PMID
1180:ISSN
1128:PMID
1110:ISSN
1066:PMID
823:The
675:and
629:(37
477:polo
103:news
1944:S26
1935:ICD
1892:doi
1861:doi
1794:doi
1757:doi
1753:147
1640:PMC
1632:doi
1552:doi
1548:101
1511:PMC
1495:doi
1261:doi
1257:362
1215:doi
1211:145
1172:doi
1118:PMC
1102:doi
1056:doi
808:to
571:in
530:or
405:If
336:CPR
86:by
2188::
2007:.
1988::
1964::
1953::
1942::
1939:10
1898:.
1888:23
1886:.
1869:.
1857:50
1855:.
1851:.
1800:.
1790:89
1788:.
1765:.
1751:.
1747:.
1721:.
1696:.
1670:.
1648:.
1638:.
1628:27
1626:.
1622:.
1599:.
1576:.
1568:.
1560:.
1546:.
1542:.
1519:.
1509:.
1501:.
1491:10
1489:.
1485:.
1483:)"
1469:^
1452:.
1425:^
1408:.
1382:.
1353:.
1349:.
1323:.
1292:.
1281:^
1267:.
1255:.
1243:^
1229:.
1221:.
1209:.
1186:.
1178:.
1168:10
1166:.
1140:^
1126:.
1116:.
1108:.
1096:.
1092:.
1078:^
1064:.
1050:.
1046:.
984:^
538:.
503:,
499:,
495:,
491:,
483:,
479:,
475:,
338:,
48:.
2103:/
2098::
2078::
2044:e
2037:t
2030:v
1937:-
1927:D
1906:.
1894::
1877:.
1863::
1831:.
1808:.
1796::
1773:.
1759::
1732:.
1707:.
1682:.
1656:.
1634::
1584:.
1554::
1527:.
1497::
1463:.
1419:.
1394:.
1368:.
1334:.
1308:.
1275:.
1263::
1237:.
1217::
1194:.
1174::
1134:.
1104::
1098:1
1072:.
1058::
1052:5
797:)
783:2
779:v
775:m
769:2
766:1
760:=
755:k
751:E
368:(
234:)
228:(
216:)
210:(
205:)
201:(
183:.
153:)
147:(
142:)
138:(
128:·
121:·
114:·
107:·
80:.
55:)
51:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
