Commotio cordis…once again: Unusual occurrence in a noncontact sport

Key Teaching Points•Chest blow–induced ventricular tachycardia and cardiac arrest in the absence of underlying cardiac disease (commotio cordis) is an uncommon but important cause of sudden death, often in young people.•Commotio cordis occurs in athletes during competitive or recreational sports, or is associated with routine everyday activities.•Commotio cordis chest blows can be substantial or alternatively appear trivial and counterintuitive (as in the subject of this report).•Timely recognition of a commotio cordis event is paramount, as cardiac arrest is reversible with prompt cardiopulmonary resuscitation / defibrillation.•Although incompletely understood, the mechanism of commotio cordis requires a precise timing of the blow over the heart to a narrow 20 ms window at the upstroke of the T wave. •Chest blow–induced ventricular tachycardia and cardiac arrest in the absence of underlying cardiac disease (commotio cordis) is an uncommon but important cause of sudden death, often in young people.•Commotio cordis occurs in athletes during competitive or recreational sports, or is associated with routine everyday activities.•Commotio cordis chest blows can be substantial or alternatively appear trivial and counterintuitive (as in the subject of this report).•Timely recognition of a commotio cordis event is paramount, as cardiac arrest is reversible with prompt cardiopulmonary resuscitation / defibrillation.•Although incompletely understood, the mechanism of commotio cordis requires a precise timing of the blow over the heart to a narrow 20 ms window at the upstroke of the T wave.