Commotio cordis without arrhythmic event and resuscitation: ECG, echocardiographic, angiographic and cardiovascular...

Area of Science:

• Cardiology
• Sports Medicine
• Emergency Medicine

Background:

• Commotio cordis, a rare event, results from blunt chest trauma.
• It typically causes ventricular arrhythmias and can be fatal.
• This case presents a unique scenario without arrhythmias.

Observation:

• A healthy 17-year-old male experienced commotio cordis after blunt chest trauma.
• Initial evaluation showed ECG abnormalities, elevated troponin I, and pericardial effusion.
• Cardiac imaging, including angiography and cardiovascular MRI, confirmed localized myocardial injury.

Findings:

• The patient did not exhibit any cardiac arrhythmias.
• Cardiovascular MRI revealed delayed enhancement in the affected myocardial zone.
• Follow-up echocardiography demonstrated resolution of pericardial effusion and improved ECG findings.

Implications:

• This case highlights the importance of comprehensive cardiac evaluation in suspected commotio cordis.
• It suggests that commotio cordis can occur without arrhythmias, challenging typical presentations.
• Extensive imaging aids in understanding the extent and recovery of myocardial injury.