With Dr. Benjamin Gardner, M.D. News Faculty Guest Writer
By definition, a cardiac concussion is a “blunt, non-penetrating....chest impact that causes arrhythmia or sudden death without evidence of heart injury at autopsy.” (1) In other words, this is the relatively unusual, but real death that comes from a baseball, hockey puck or lacrosse ball hitting a player in the middle of the upper chest and stopping the heart or causing a potentially fatal erratic heart rhythm. The actual reason for this happening is not fully known, but it is thought to be an issue of the timing of the blow, not the actual strength of the blow. Experts believe that the blow may occur during the narrow window within the repolarization phase of the cardiac cycle. Most are fatal; for example, the Captain of the Cornell lacrosse team died after a lacrosse ball hit his chest in March of 2004, but fortunately a student at one of our competitor prep schools survived a few years ago.
The level of protective equipment may or may not protect players. Although younger players with thinner chest walls and softer tissue are thought to be more at risk, there have been fatalities with chest protection... and without.
An AED (Automatic External Defibrillator), if used soon after the event, may save a life. Choate now owns five AED’s which are intended to shock a heart back into a normal rhythm. Since time is critical, if a cardiac concussion is suspected, CPR should be initiated if the player does not have a pulse and someone should call for a defibrillator. The trainers, health center staff, equipment room staff and community safety are among those on campus who have been trained in AED use.
Choate AED’s are located:
1. With trainers, who have them at most contact sport games or have access to the one in the equipment room.
2. With community safety each of the two community safety vehicles has a defibrillator.
3. In the SAC. There is one in a cabinet by the post office.
4. In the Health center.
sources: The Physician and Sportsmedicine, November, 2000, page 31. Revised from a Choate News article, Doc Notes, 4/13/01. US Lacrosse Statement, March 22, 2004 (Laxpower.com)
