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Updated: Jul 16, 2026

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Published on: September 21, 2018

Cardiac concussion (commotio cordis).

Rahim Valani¹, Angelo Mikrogianakis, Ran D Goldman

¹Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.

|March 24, 2007

Summary

Commotio cordis, or cardiac concussion, is a sudden heart rhythm disturbance caused by blunt chest trauma in children. Immediate collapse can occur, but prevention through safety gear and defibrillation is key.

Area of Science:

Pediatric Cardiology
Sports Medicine
Trauma Surgery

Background:

Blunt chest trauma can cause myocardial injuries in children.
Commotio cordis occurs when the precordium is struck during a vulnerable cardiac cycle phase.
Patients typically have no prior cardiac issues, and autopsies show no structural heart damage.

Purpose of the Study:

To describe the phenomenon of commotio cordis in pediatric blunt chest trauma.
To outline the clinical presentation and underlying mechanism.
To emphasize preventative strategies.

Main Methods:

Review of clinical presentations of commotio cordis.
Analysis of the timing of precordial impact relative to the cardiac cycle.
Discussion of autopsy findings in affected patients.

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Main Results:

Commotio cordis presents as immediate collapse due to lethal arrhythmia.
The injury mechanism involves impact during the vulnerable repolarization period.
No predisposing cardiac conditions or autopsy-confirmed heart damage are found.

Conclusions:

Commotio cordis is a distinct entity in pediatric blunt chest trauma.
Immediate collapse is the hallmark presentation.
Prevention via safety equipment and prompt defibrillation is crucial.