Complete Heart Block Following a Blow on the Chest by a Soccer Ball: A Rare Manifestation of Commotio Cordis

Abstract

Commotio cordis is a rare type of blunt cardiac injury in which low impact chest trauma causes sudden cardiac arrest, usually occurs from being struck by a projectile during sports. The most common arrhythmia during commotio cordis is ventricular fibrillation, although complete heart block and an idioventricular rhythm have also been reported. We describe a case of a young patient who presented with a persistent third-degree atrioventricular block and a left bundle branch block, following blunt chest trauma, as a result of blow by soccer ball and subsequently needed a permanent pacemaker.

Investigation of Sudden Death in Athletes: The Fittest Bodies in the Morgue

“…As expected, the occurrence is highest in sports with propelled projectiles such as baseball, softball, ice hockey, and lacrosse (33). Although not as common, commotio cordis is also seen in football, soccer, cricket (40, 41), and with impacts of body parts including fists, knees, shoulders, and feet (42, 43). Chest impact over the cardiac silhouette interrupts the cardiac conduction cycle and results in ventricular fibrillation; collapse is typically very sudden but with immediate defibrillation can be survivable (44).…”

Contusio CordisAssociated with Atrioventricular Block and Tricuspid Regurgitation

“…The accurate incidence of both entities is unknown, because there is no systematic way to register all cases; however, although rare in the literature, they are believed to be more common than reported 3 , 6 . Contusio cordis associated with complete atrioventricular block (CAVB) is an even rarer condition, with few cases reported 7 . The objective of the present study is to report a case of contusio cordis associated with CAVB and tricuspid regurgitation (TR).…”

Third‐Degree Atrioventricular Block Following Commotio Cordis

“…I read with interest the case report by Thakar et al that described third‐degree atrioventricular (AV) block after blunt chest trauma in a 23‐year‐old man who was struck with a soccer ball . Undoubtedly, this is a rare occurrence given the prevalence of blunt chest trauma in athletics events, motor vehicle collisions, etc.…”