Key result
A 67-year-old man who developed complete A-V block following blunt chest trauma (commotio cordis) was successfully resuscitated with cardiopulmonary resuscitation and pacing.
Case Report (n=1)
No
Commotio cordis can present as fatal cardiac conduction disturbance (complete A-V block) after blunt chest trauma even without structural myocardial damage, requiring prompt CPR and pacing.
Commotio cordis may cause isolated complete AV block; extends conduction disturbance spectrum but leaves open optimal resuscitation protocols.
We reported a case of fatal cardiac conduction disturbance induced by blunt chest trauma, “commotio cordis.” A 67-year-old man experienced thoracic impact and complete A-V block on hospital arrival, then complete A-V block without escaped beats 1.5 hours after admission. He was resuscitated by cardiopulmonary resuscitation (CPR) including transcutaneous/transvenous pacing. No obvious myocardial damage showing structural injury due to trauma was seen in echocardiographic or biochemical surveys. Electrophysiological studies indicated that preexisting cardiac incapability (right bundle branch block) was not responsible for this posttraumatic episode of fatal arrhythmia. Commotio cordis, fatal cardiac conduction disturbance induced by relatively minor chest wall impact should be taken into consideration under intense monitoring in a trauma center setting and warrants further investigation.
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Moroe et al. (2002) conducted a case report in Commotio cordis (complete A-V block induced by blunt chest trauma) (n=1). Cardiopulmonary resuscitation (CPR) including transcutaneous and transvenous pacing was evaluated on Patient survival and recovery. A 67-year-old man who developed complete A-V block following blunt chest trauma (commotio cordis) was successfully resuscitated with cardiopulmonary resuscitation and pacing.
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