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Damar Hamlin may have collapsed due to Commotio Cordis: what is it?

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Buffalo Bills safety Damar Hamlin remains sedated on a ventilator at the hospital where he was taken after collapse on the ground and go into cardiac arrest at an NFL game in January. 2.

Hamlin’s uncle Dorrian Glenn spoke about his 24-year-old nephew’s condition during an interview with CNN on the evening of Jan. 3, sharing that Hamlin was still in critical condition Tuesday evening.

During Monday’s game against the Cincinnati Bengals, Hamlin collapsed after a tackle and was resuscitated on the field, according to a Buffalo Bills statement released in early January. 3. The team confirmed that Hamlin went into cardiac arrest and was rushed to the University of Cincinnati Medical Center.

Indianapolis Colts vs. Buffalo Bills
Buffalo Bills’ Damar Hamlin on the sidelines in a preseason game against the Indianapolis Colts on August 28. 13, 2022, in Orchard Park, New York. Timothy T. Ludwig/Getty Images

“I’m not a crier, but I’ve never cried so hard in my life.” Glenn told CNN. “Just to know, for example, that my nephew basically died in the field and they brought him back to life.”

Glenn told CNN the purpose of the ventilator is to relieve his nephew’s lungs, and the sedation is meant to help “his body…heal much faster” than if he were awake.

Glenn told CNN that Hamlin suffered lung damage and doctors were working to get him to breathe on his own again. He told CNN that his nephew was “turned onto his stomach” due to blood on his lungs.

“It seems to have a positive trend,” Glenn told CNN.

The night after the game, Hamlin remained in the intensive care unit, according to an update of the Buffalo Bills on the afternoon of January 1st. 3.

Damar Hamlin #3 of the Buffalo Bills is dragged off the field in an ambulance after sustaining an injury during the first quarter of an NFL football game against the Cincinnati Bengals at Paycor Stadium on January 2, 2023 in Cincinnati, Ohio.
Damar Hamlin of the Buffalo Bills is dragged off the field in an ambulance after sustaining an injury during the first quarter of an NFL football game against the Cincinnati Bengals at Paycor Stadium on January 29, 2020. 2, 2023, in Cincinnati . Kevin Sabitus/Getty Images

After collapsing, Hamlin received CPR in the field for several minutes, according to ESPN commentators calling the game, as players and fans watched in shock. Former Buffalo Bills player Eric Wood, who was at the stadium on Monday, called the moment “incredible”. in a TODAY segment that aired in January. 3. He recalled the “complete silence” before Hamlin was taken to an ambulance.

In footage of the tackle, Hamlin can be seen taking a hard blow to the chest – after getting up and taking a few steps, his body goes limp and he collapses onto his back.

“Guys stay on the pitch with injuries all the time, but from the moment Damar hit the turf, it seemed like something was different, (that) this situation was much more serious than normal,” said Wood.

While it’s common to see players injure their knees, Wood said, seeing a player require CPR on the field is “pretty unprecedented in the NFL” and has left both teams “completely shaken.”

In their first statement Since the incident, Hamlin’s family have expressed their “sincere gratitude for the love and support Damar has shown during this difficult time” and added that they will post updates as they become available.

The University of Cincinnati Medical Center has yet to provide updates on Hamlin’s condition, by NBC Sports. “We don’t know exactly what happened, (and) we don’t know exactly what his condition was prior to that,” NBC News senior medical correspondent Dr. John Torres said. said TODAY in a segment that aired in January. 3.

What is cordis concussion?

Many medical professionals are discussing what could have caused Hamlin’s cardiac arrest. The exact cause has not yet been confirmed. “Assuming he’s a healthy athlete, one condition that a lot of experts are looking at is something called commotio cordis,” Torres said.

Hamlin had no health or heart problems, according to his uncle.

Commotio cordis is Latin for ‘stirring of the heart,’ Torres added, and it happens when a person is struck in the chest with a certain amount of force at a very specific point in the heart cycle, when electricity is flowing to one side. . from the heart to another. “So that can trigger cardiac arrest. … It can be a life-threatening condition,” Torres said.

According to Boston-based cardiologist Dr. Khalid Aljabri, commotio cordis is “not associated with pre-existing heart damage or COVID.”

Commotio cordis is a very rare occurrence, Torres added. Since 1995, there have only been 200 documented cases in the United States. According to University of Connecticut Korey Stringer Institutededicated to the prevention of sudden death in sport.

“For the past two decades, we’ve recognized that you can get this non-penetrating blunt trauma to your chest. It happens in baseball (and) hockey with hockey pucks,” Dr. Natalie Azar said. TODAY in a segment that aired January 1. 3.

Can commotio cordis occur from a tackle?

“So how could this have happened (during) what looked like… a very typical tackle?” Azzar wondered. If the blow to the chest occurs at exactly the right time in the heart cycle, she continued, the impact can trigger a life-threatening arrhythmia (or abnormal heart rhythm) called ventricular fibrillation. Life-threatening arrhythmias cause most sudden cardiac arrests, according to Cleveland Clinic.

Even a low-impact projectile or a strike in the middle of the chest with one hand (during martial arts, for example) can be enough to cause cardiac arrhythmia, according to the Korey Stringer Institute.

In addition to the right time, the impact must occur in the right place, experts say.

“Hits like this happen 200, 300 times every weekend in the NFL. … There was nothing extraordinary or particularly different about the shot. That’s probably where he was shot in the chest,” NBC Sports columnist Peter King told TODAY in a segment that aired Jan. 3.

Can you survive commotio cordis?

When this condition occurs, it’s extremely important to start CPR and defibrillation in a timely manner, Torres said.

“You want to start CPR within two minutes, and they had defibrillators on hand which I’m sure they used during CPR to try to get him to revive him,” he said, adding that paramedics paramedics who responded immediately likely saved Hamlin’s life.

According to a 2009 literature review of commotio cordis published in Sport Healthresuscitation within 3 minutes resulted in a 25% survival rate, and this rate dropped to 3% when resuscitation was delayed beyond 3 minutes.

Cardiac arrest is one of the most urgent diseases in all of medicine. If CPR is not started immediately, chances of survival drop by 10-15% per minute without CPR,” Dr. Benjamin Abella, director of the Center for Resuscitation Science at the University of Pennsylvania, told TODAY .com.

“It’s a very horrible and rare thing to witness live cardiac arrest…it’s a real trauma,” he continued, adding that he hopes family, teammates, coaches and other Hamlin Witnesses will get the support and resources they need to heal. . .

Azar added: “Congratulations to the paramedics and everyone who (acted) on the scene.”

After what happened on the pitch, the next step was to get Hamlin to the hospital for further evaluation and treatment, Torres said.

“What’s happening right now is he’s sedated and…he has an artificial tube that’s helping him breathe,” Azar said, adding that it will be essential for doctors to monitor the condition. Hamlin’s neurological status over the next 24 to 72 hours.

“The biggest concern when the heart stops is that your brain isn’t getting enough oxygen,” Azar said. “Brain activity shuts down very, very soon after someone has had a cardiac arrest, within minutes.” She added that it’s unclear exactly how long it took before Hamlin’s heartbeat was restored.

“We’ll know in the next 24 hours or so how he’s going to fare,” Torres said.

What does commotio cordis recovery look like?

Even if CPR is successful after cardiac arrest, patients still have a tough road ahead, Abella says.

“When you look across the United States, the survival rate from when cardiac arrest strikes to being discharged from hospital is less than 20 percent,” Abella says. It also depends on when the CPR started, the quality of the CPR and the availability of automated external defibrillators (AEDs), he adds.

While it’s very hard to say what Hamlin’s recovery will be like, Abella says one thing is certain, recovery will be slow – it could take days or even weeks to fully understand. the extent of his injuries.

Brain damage is a common problem after cardiac arrest to varying degrees in different people. … We’ll have to keep hoping for the best, but only time will tell,” says Abella.

But there are glimmers of hope. “There are well-known cases of athletes who have fully recovered from cardiac arrest – notably, Fabrice Muamba in 2012 and Christian Eriksen (in 2021),” explains Abella, adding that both players also underwent prolonged CPR after their cardiac arrest events. ., like Hamlin.

Other possible conditions that could explain Hamlin’s cardiac arrest include an aneurysm that ruptured or an underlying heart defect, Azar said. “We don’t know for sure, but given when and how it happened, (commotio cordis) is what most experts believe happened,” she said. Explain.

According to Abella, professional athletes typically undergo extensive medical screenings and evaluations, so it would be surprising to find out now that Hamlin has an underlying heart disease or disorder. “(It) makes me think it was probably a blow to the chest in a healthy heart that caused the cardiac arrest,” says Abella, adding that nothing is certain at this point and we should find out more. soon.

“We are crossing our fingers that he gets back to what he wants to do, playing football – which is possible – but above all that he gets back to a normal life,” Torres said.

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