A case of Commotio cordis in a young child caused by a fall

Area of Science:

• Pediatrics
• Cardiology
• Emergency Medicine

Background:

• Commotio cordis is a rare but life-threatening event.
• Sudden cardiac arrest in children typically has underlying cardiac pathology.

Observation:

• A young child experienced sudden cardiac arrest, including unconsciousness, apnea, and cyanosis, after falling chest-first.
• Ventricular fibrillation was diagnosed upon emergency services arrival.
• Extensive cardiac and systemic investigations ruled out pre-existing conditions or trauma.

Findings:

• The child's ventricular fibrillation responded successfully to biphasic defibrillation (3 J/kg).
• No evidence of chest trauma, brain injury, or underlying cardiac abnormalities (e.g., long QT, Brugada syndrome) was found.
• Neurological recovery was complete after therapeutic hypothermia and mechanical ventilation.

Implications:

• This case highlights commotio cordis as a critical differential diagnosis in pediatric sudden cardiac arrest, even without direct trauma.
• Highlights the importance of immediate cardiopulmonary resuscitation and defibrillation in suspected commotio cordis.
• Emphasizes the need for thorough investigation to exclude other causes of cardiac arrest in children.