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Cardiac Concussion


Presentation

  • The usual clinical presentation is that of immediate collapse secondary to a lethal arrhythmia. Prevention is the cornerstone of potentially decreasing the incidence with the aid of safety equipment and, possibly, immediate defibrillation.[ncbi.nlm.nih.gov]
  • Two male patients presented to Emergency Department with moderate anterior chest pain after motor vehicle crash showed transient anterior ST segment elevation at chest lead V2 and V3 with raised creatine kinase and normal troponin T.[medicineandhealthukm.com]
  • Club and teams that participate in the PSPL must have all their coaches and assistant coaches complete an online Sudden Cardiac Arrest prevention program and present a certificate of completion to their club/team prior to the start of the 2015-2016 season[pugetsoundpremierleague.com]
  • Screenings are free of charge and a parent or guardian is asked to be present. Registration is required. To register and schedule an appointment time, parents/guardians are asked to email Teamlink@rwjbh.org. For more information about the Matthew J.[patch.com]
  • Screenings are free of charge and a parent or guardian is asked to be present. ABOUT MATTHEW J. MORAHAN III Before finding his true athletic calling on the links, Matthew participated in little league, recreational football, and swimming.[forkedrivergazette.com]
Pain
  • Two male patients presented to Emergency Department with moderate anterior chest pain after motor vehicle crash showed transient anterior ST segment elevation at chest lead V2 and V3 with raised creatine kinase and normal troponin T.[medicineandhealthukm.com]
  • The following symptoms during or after physical activity are signs that a student-athlete may have a heart condition: Chest pain Fainting Abnormally heavy breathing Irregular heartbeat Fatigue and weakness Dizziness Nausea and/or vomiting These symptoms[barnabashealth.org]
  • Fainting/blackouts (especially during exercise) Dizziness Unusual fatigue/weakness Chest pain Shortness of breath Nausea/vomiting Palpitations (heart is beating unusually fast or skipping beats) Family history of sudden cardiac arrest at age 50 ANY of[wiaawi.org]
  • Chest pain or chest tightness with exercise. Shortness of breath. Syncope - fainting or passing out.[uiltexas.org]
  • Those that do complain most commonly complain of chest pain, but this can be confounded by the presence of chest wall injuries.[aast.org]
Weakness
  • The following symptoms during or after physical activity are signs that a student-athlete may have a heart condition: Chest pain Fainting Abnormally heavy breathing Irregular heartbeat Fatigue and weakness Dizziness Nausea and/or vomiting These symptoms[barnabashealth.org]
  • Fainting/blackouts (especially during exercise) Dizziness Unusual fatigue/weakness Chest pain Shortness of breath Nausea/vomiting Palpitations (heart is beating unusually fast or skipping beats) Family history of sudden cardiac arrest at age 50 ANY of[wiaawi.org]
  • The wall of the aorta, the main artery from the heart, can become weak and rupture, especially during exercise.[uiltexas.org]
Pathologist
  • This photograph and adequate records can be used to refute any charges against the pathologist or assistants for the poor condition of a body after its release.[ncbi.nlm.nih.gov]
  • […] normal pericardial sac, the coronary arteries arises normally and free from atherosclerosis, the chambers and valves are proportionate, with normal myocardium, and atrial and ventricular septa… The toxicological report comes back normal, and the forensic pathologist[lifeinthefastlane.com]
Epilepsy
  • Medical Center (CMC) is a fully accredited acute care hospital and offers a comprehensive array of services including advanced cancer care, sophisticated neurology and neurosurgery services including a neuro-interventional lab with a bi-plane, a level 3 Epilepsy[forkedrivergazette.com]
  • Additionally, Palma and Benarroch (2014) reviewed non-traumatic cerebral illnesses which impair HRV, including epilepsy, ischemic, and hemorrhagic stroke and neurodegenerative diseases, such as Parkinson’s.[frontiersin.org]
Vomiting
  • The following symptoms during or after physical activity are signs that a student-athlete may have a heart condition: Chest pain Fainting Abnormally heavy breathing Irregular heartbeat Fatigue and weakness Dizziness Nausea and/or vomiting These symptoms[barnabashealth.org]
  • Fainting/blackouts (especially during exercise) Dizziness Unusual fatigue/weakness Chest pain Shortness of breath Nausea/vomiting Palpitations (heart is beating unusually fast or skipping beats) Family history of sudden cardiac arrest at age 50 ANY of[wiaawi.org]
  • […] ground immediately on impact and others remained standing, but all of them then briefly performed some kind of conscious physical activity or movement — opening their eyes, rising to a standing position (or attempting to do so), speaking or crying, vomiting[nejm.org]
Nausea
  • If you or a loved one has sustained a blow to the head, you should consult with a doctor if you experience headaches, nausea, dizziness, or any other abnormal behavior. At MJM, we perform a non-invasive concussion screening known as ImPACT.[barnabashealth.org]
  • Fainting/blackouts (especially during exercise) Dizziness Unusual fatigue/weakness Chest pain Shortness of breath Nausea/vomiting Palpitations (heart is beating unusually fast or skipping beats) Family history of sudden cardiac arrest at age 50 ANY of[wiaawi.org]
Heart Disease
  • At Sibley Heart Center Cardiology, we offer our Cardiac Genetics Program which cares for children and young adults who have: A genetic heart disease, such as long QT syndrome, dilated cardiomyopathy and coronary artery disease, or who are suspected of[choa.org]
  • Ninety percent of professional athletes today are tested for heart disease regularly.[qz.com]
  • It is a form of ventricular fibrillation (V-Fib), not mechanical damage to the heart muscle or surrounding organs, and not the result of heart disease, so this can happen to anybody![portneuf.org]
  • Conclusions Management of athletes with ICDs should be individualized to the patient, according to the heart disease and sport in question.[elsevier.pt]
  • Sudden cardiac death in athletes is usually caused by a previously unsuspected heart disease or disorder. The occurrence of sudden cardiac death is thought to be in the range of 1 out of 100,000 to 1 out of 300,000 high school age athletes.[uiltexas.org]
Tachycardia
  • An electrical malfunction (short‐circuit) causes the bottom chambers of the heart (ventricles) to beat dangerously fast (ventricular tachycardia or fibrillation) and disrupts the pumping ability of the heart.[wiaawi.org]
  • Patients generally present to ED unresponsive, apneic and pulseless with initial rhythm analysis generally showing ventricular fibrillation or ventricular tachycardia.[lifeinthefastlane.com]
  • All participants were under beta-blocker therapy to prevent inappropriate shocks due to sinus or ventricular tachycardia.[elsevier.pt]
  • AAST Injury Scale: Cardiac Injuries Grade I Blunt cardiac injury with minor EKG abnormality (non specific ST of T wave changes, premature atrial or ventricular contractions, or persistent sinus tachycardia Blunt or penetrating pericardial wound without[aast.org]
  • That also explains why the heart becomes more vulnerable when it is physically strained by sports activities: The increase in heart rate (exercise tachycardia ) may double the probability above (e.g., with 120 beats per minute the cardiac cycle shortens[en.wikipedia.org]
Chest Pain
  • Two male patients presented to Emergency Department with moderate anterior chest pain after motor vehicle crash showed transient anterior ST segment elevation at chest lead V2 and V3 with raised creatine kinase and normal troponin T.[medicineandhealthukm.com]
  • The following symptoms during or after physical activity are signs that a student-athlete may have a heart condition: Chest pain Fainting Abnormally heavy breathing Irregular heartbeat Fatigue and weakness Dizziness Nausea and/or vomiting These symptoms[barnabashealth.org]
  • Fainting/blackouts (especially during exercise) Dizziness Unusual fatigue/weakness Chest pain Shortness of breath Nausea/vomiting Palpitations (heart is beating unusually fast or skipping beats) Family history of sudden cardiac arrest at age 50 ANY of[wiaawi.org]
  • Chest pain or chest tightness with exercise. Shortness of breath. Syncope - fainting or passing out.[uiltexas.org]
  • Those that do complain most commonly complain of chest pain, but this can be confounded by the presence of chest wall injuries.[aast.org]
Heart Block
  • A small part of the imparted kinetic energy may be converted to electrical impulses (Hirsch and Adams 1993) A thump in the cardiac cycle at other times gives rise to ST elevation and transient heart block.[forensicmed.co.uk]
  • block or ischemic changes without cardiac failure Penetrating tangential cardiac wound, up to but not extending through endocardium, without tamponade Grade III Blunt cardiac injury with sustained or multifocal ventricular contracations Blunt or penetrating[aast.org]
Contusion
  • Cardiac concussions are clinically, pathologically, and chemically different from a cardiac contusion.[ncbi.nlm.nih.gov]
  • See also cardiac contusion.[oxfordreference.com]
  • See also cardiac contusion. Subjects: Sports and Exercise Medicine. Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or login to access all content.[oxfordindex.oup.com]
  • Conventional definition of cardiac concussion (commotion cordis) and cardiac contusion may be unsuitable to describe these cases. Therefore, we propose the diagnosis of focal cardiac concussion.[medicineandhealthukm.com]
Abnormal Behavior
  • If you or a loved one has sustained a blow to the head, you should consult with a doctor if you experience headaches, nausea, dizziness, or any other abnormal behavior. At MJM, we perform a non-invasive concussion screening known as ImPACT.[barnabashealth.org]
Impulsivity
  • A small part of the imparted kinetic energy may be converted to electrical impulses (Hirsch and Adams 1993) A thump in the cardiac cycle at other times gives rise to ST elevation and transient heart block.[forensicmed.co.uk]

Workup

ST Elevation
  • In addition, the effect of K/ATP channels (which are responsible for ST elevation and contribute to risk of VF in ischaemia) have received much interest, as their blocker ( glibenclamide ) reduces ST elevation and the incidence of VF following induced[forensicmed.co.uk]
Electrocardiogram Change
  • The electrocardiogram changes fully resolved after 24 hours. Both patients were discharged uneventfully after 24 hours monitoring in Emergency Department short-stay ward.[medicineandhealthukm.com]
Electrocardiogram Change
  • The electrocardiogram changes fully resolved after 24 hours. Both patients were discharged uneventfully after 24 hours monitoring in Emergency Department short-stay ward.[medicineandhealthukm.com]

Treatment

  • We want to help your family understand: Your child’s diagnosis, the course of his disorder and ways to manage it How your child’s family history affects his condition and treatment The risk of other family members having the same condition Possible treatment[choa.org]
  • HRV measurements can be done daily and easily to help guide concussion treatment and assure the treatment is promoting proper recovery in conjunction with other assessments and protocols.[hrvcourse.com]
  • To utilize TH for this patient, military physicians with limited local resources employed a telemedical approach to obtain a hypothermia protocol to develop a successful treatment plan.[scinapse.io]
  • After multiple clinical studies, The Eastern Association for the Surgery of Trauma (EAST) has generated the following guidelines for evaluation and treatment of myocardial contusion.[aast.org]
  • The most effective treatment for sudden cardiac arrest and, indeed, the only effective response to commotio cordis, is the timely delivery of a life-saving shock or defibrillation.[uslacrosse.org]

Prognosis

  • BCI should be highly suspected when these other injuries are presents, and these other injuries may greatly affect the patients overall prognosis.[aast.org]

Etiology

  • However, Mild TBI or concussion injuries are rarely lateralized, typically being more diffuse in etiology and MOI. Williamson et al. (2013) propose a similar model.[frontiersin.org]

Epidemiology

  • Estes, M.(2010).NEJM,362:10 Epidemiology: More than 224 cases have been reported to the US Commotio Cordis Registry since 1995, however its estimated that many more cases have not been reported.[lifeinthefastlane.com]
  • Definition and epidemiology of sudden cardiac death SCD, mainly caused by malignant ventricular arrhythmias, 6 is one of the leading causes ( 50%) of cardiovascular death worldwide.[elsevier.pt]
  • Epidemiology and Diagnosis of Traumatic Brain Injury First, it is necessary to review the etiology and severity of TBI to understand where concussions fall along the continuum of severity of injury and how they may affect HRV.[frontiersin.org]
Sex distribution
Age distribution

Pathophysiology

  • The functional dynamics of the heart, with ventricular arrythmias and conduction disturbances, serve as the pathophysiological basis of this condition. As a cause of death in vehicular accidents, it is less common than other causes.[ncbi.nlm.nih.gov]
  • […] infarction of childhood Arrhythmogenic right ventricular dysplasia (ARVD) Viral myocarditis Anomalous left coronary artery from the pulmonary artery (ALCAPA) Electrolyte abnormalities [See Cardiovascular Curveball #003 for a case of HOCM and QT prolongation] Pathophysiology[lifeinthefastlane.com]
  • Research has shown implications for HRV in physiology, pathophysiology, psychology, psychopathology, cognition, and neurocognitive impairment ( Gevirtz, 2013 ).[frontiersin.org]

Prevention

  • Sudden Cardiac Arrest Prevention Act On May 30th, Governor Corbett signed into law the “Sudden Cardiac Arrest Prevention Act,” also known as Act 59 of 2012 (originally House Bill 1610).[allentowndiocese.org]
  • Abstracts from the IOC World Conference on Prevention of Injury & Illness in Sport, Monaco 2014 THE IMPACT OF CONCUSSION ON CARDIAC AUTONOMIC FUNCTION: A SYSTEMATIC REVIEW OF EVIDENCE FOR RECOVERY AND PREVENTION T Blake 1, C McKay 1, WH Meeuwisse 1, 2[bjsm.bmj.com]
  • Safety and prevention is a priority to Lucky Lax which is why we have partnered with Orthopedic One.[luckylax.com]
  • These courses include: Concussion Awareness and Prevention and Response to Heat Related Medical Issues.[doe.in.gov]
  • In fact, tests on the majority of commercially available chest guards found that there was not a significant difference in preventing Commotio cordis between wearing the protection and not.[sporttechie.com]

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