Dr. Barry Maron was watching the Monday night game between the Buffalo Bills and Cincinnati Bengals when he saw Damar Hamlin absorb a hit, rise and collapse. Everything about the injury immediately suggested commotio cordis, he said.
"Clinically it seemed classic because there was the chest blow and then for five seconds or so he tolerated the arrhythmia that followed. That's what usually happens," Maron said.
Maron, a cardiologist at Lahey Hospital & Medical Center in Burlington, Massachusetts, is considered one of the world's top researchers on the subject. With the help of Maron and other research, here are some key questions and answers about the injury Hamlin suffered, which appears consistent with commotio cordis, and what it means for his health:
What is commotio cordis?
Commotio cordis is a rare but dangerous injury to the heart that causes cardiac arrest, and in many cases, death. Unlike most cases of sudden cardiac arrest, commotio cordis is not the result of a preexisting condition. "The astounding thing about commotio cordis is that it's a blow that's timed exactly to a 30-millisecond window" during the heartbeat, Maron said. "Very few blows will be timed that way. It's just the luck of the draw."
The National Institutes of Health reports that there are typically fewer than 30 cases nationwide every year.
Such a blow to the chest -- most commonly from a thrown or batted ball or puck -- can disrupt the heart's rhythm, causing what is known as ventricular fibrillation. It is common for people who have suffered such a blow to remain conscious and mobile for a few seconds before they lose consciousness, as Hamlin did before he collapsed Monday night. When someone suffers such a blow, Maron and others say, it is crucial to apply a defibrillator to the patient as quickly as possible. More than half can be revived without permanent injury, he said. But it's vital to restore blood flow to get oxygen to the brain and organs.
How is commotio cordis different from other heart issues?
High-profile cardiac deaths in sports are usually the result of heart disease or drug use, not injury. Some, such as G League basketball player Zeke Upshaw, suffered from an undiagnosed genetic disease known as hypertrophic cardiomyopathy, a thickening of the heart muscle. Others, such NFL player Chuck Hughes, who died on the field in 1971, had undiagnosed coronary disease.
But with commotio cordis, there is no disease and nothing to detect before it occurs. It is simply an injury with exceptionally bad timing.
There have been a handful of recorded cases in youth and high school football, and researchers believe that younger athletes are at greater risk because of their underdeveloped ribcages.
What is the biggest danger to Damar Hamlin right now?
The problem now might not be his heart, but rather how much damage Hamlin's brain and organs might have suffered while they were deprived of oxygen.
According to Maron and other experts, time is the crucial factor, and the fact that Hamlin needed resuscitation for multiple minutes is troubling. (Hamlin received oxygen, according to the ESPN broadcast, as he was placed in the ambulance and taken off the field some 16 minutes after he collapsed. He then was driven to the hospital.)
Typically if the brain is deprived of oxygen for more than five minutes, it can suffer permanent injury and a patient could suffer multiple organ failure. The treatment Hamlin is reportedly receiving, lowering his body temperature, is consistent with protocols to preserve the brain and organs.
How common is commotio cordis in football?
Commotio cordis is rare to begin with, but it almost never occurs in football because of the padding players wear. Typically commotio cordis is caused by a direct, forceful and unprotected blow to the heart, such as a thrown or batted baseball, softball or hockey puck. Padding diffuses the energy of that blow.
Re: Week 17 Games
Posted: 04 Jan 2023 12:00
by BSA
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From what I've been reading- 2 separate but connected issues right now.
Lung damage from the cardiac arrest and subsequent intubation / aspiration of fluids into the lungs. Neurological damage from oxygen deprivation to the brain. They gave Damar CPR for many minutes both on the field and again at the ER and during that time, some parts of his brain just weren't getting enough oxygen. Which parts, or how much is TBD, and there's a big difference between hypoxic ( low oxygen) and anoxic ( no oxygen) in terms of recovery
They'll try to wean him off of the oxygen ( went from 100 % down to 50%) and see if his brain reflexes and initiates breathing mechanism on his own. The recent update that they flipped Damar over into the prone position is interesting. That move used to mean that the lung damage is significant and he's not responding well to the lower levels of supplemental oxygen . However, during COVID the ER docs learned a lot and had more success using vents on patients in the prone position - so this latest move could simply be the result of new vent practices.
The more important issue is neurological recovery - and we won't know about that until they can stop the sedation and take tube out
72 hours is a typical time frame post-cardiac arrest, sometimes longer. That takes us into Thursday/Friday
Its difficult to do an accurate neurological assessment when a patient is sedated, so the goal is to get lungs & heart back working on their own, clear all the meds from his system and assess his ability to do complex mental tasks. I'm also wondering if Damar suffered a concussion from hitting the turf post-arrest and that too will cloud the results of any neuro exams done now, but would resolve after a few more days.
Next few days are critical as we all hope for a positive outcome.
"The Bills say he appears to be neurologically intact."
That's HUGE ! Awesome news. And hats off to the trainer on the scene, Denny Kellington
Re: Week 17 Games
Posted: 06 Jan 2023 14:23
by Pckfn23
Re: Week 17 Games
Posted: 07 Jan 2023 19:12
by Yoop
Good news for Damar health wise and also his Charity
Many of those supporters have flocked to a GoFundMe that Hamlin set up two years ago to support a toy drive at his mother's day care in his hometown of McKee Rocks, Pennsylvania. The fundraiser had an initial goal of $2,500, but has since raised more than $8.2 million as of Saturday afternoon.
Damar Hamlin still in ICU, but improving
Hamlin remains in critical condition at the University of Cincinnati Medical Center, where he has been since his collapse. Earlier on Saturday, the Bills announced that the safety is making continued progress, continuing to breathe on his own with "excellent" neurological function.
That's pretty much the best-case scenario given where Hamlin was just a few days ago. His life was saved by EMTs on the field in Cincinnati, who performed CPR on him for 10 minutes before loading him into the ambulance. He remained unconscious until Thursday, when he doctors announced he appeared to be neurologically intact.
Good news for Damar health wise and also his Charity
Many of those supporters have flocked to a GoFundMe that Hamlin set up two years ago to support a toy drive at his mother's day care in his hometown of McKee Rocks, Pennsylvania. The fundraiser had an initial goal of $2,500, but has since raised more than $8.2 million as of Saturday afternoon.
Damar Hamlin still in ICU, but improving
Hamlin remains in critical condition at the University of Cincinnati Medical Center, where he has been since his collapse. Earlier on Saturday, the Bills announced that the safety is making continued progress, continuing to breathe on his own with "excellent" neurological function.
That's pretty much the best-case scenario given where Hamlin was just a few days ago. His life was saved by EMTs on the field in Cincinnati, who performed CPR on him for 10 minutes before loading him into the ambulance. He remained unconscious until Thursday, when he doctors announced he appeared to be neurologically intact.
This is so great! Keep hoping and praying Damar can leave the hospital soon with everything working properly. May Damar have a great future ahead of him. #3.
"The Bills say he appears to be neurologically intact."
That's HUGE ! Awesome news. And hats off to the trainer on the scene, Denny Kellington
He literally saved Damar’s life. Yes, a hero. No, I mean HERO.
They said the game ball from the first touchdown was given to him.
Re: Week 17 Games
Posted: 08 Jan 2023 15:32
by Scott4Pack
You should all look back in the highlights to see the pass that Josh Allen threw. The announcers just five seconds earlier talked about how their star WR hadn’t caught a pass in the second half yet…
So, Allen was flat-footed, about to get leveled by pass rush and he heaves a pass from about his 41 yard line to the WR inside the 5 who runs in for a touchdown. A spot-on pass at about 55 yards under pressure. How many QBs can throw that pass? I’d say only two or three. I’m not even sure that Aaron Rodgers could throw that any more (used to be that he could and did).
You should all look back in the highlights to see the pass that Josh Allen threw. The announcers just five seconds earlier talked about how their star WR hadn’t caught a pass in the second half yet…
So, Allen was flat-footed, about to get leveled by pass rush and he heaves a pass from about his 41 yard line to the WR inside the 5 who runs in for a touchdown. A spot-on pass at about 55 yards under pressure. How many QBs can throw that pass? I’d say only two or three. I’m not even sure that Aaron Rodgers could throw that any more (used to be that he could and did).
