Lethal commotio cordis: an update

Commotio cordis (CC) is a rare and potentially fatal condition characterized by sudden cardiac arrest resulting from blunt, direct, non-penetrating chest trauma occurring during a specific phase of the cardiac cycle. This article presents an overview of the current literature on lethal CC, focusing on its epidemiology, pathophysiology, clinical presentation, diagnostic challenges, and management strategies. By examining the existing evidence, this review aims to enhance understanding of lethal CC and provide insights, especially for forensic pathologist who could be called to deal with CC in forensic settings. In particular, the authors highlight the importance of comprehensive post-mortem examinations to reach a definitive diagnosis. Only this careful approach would possess the necessary strength, allowing to sustain a CC diagnosis as a cause of death in forensic settings.