Damar Hamlin May Have Collapsed Due To Commotio Cordis: What Is It?

Buffalo Bills safety Damar Hamlin remains sedated on a ventilator at the hospital he was rushed to after collapsing on the field and going into cardiac arrest during an NFL game on Jan. 2.

Hamlin’s uncle Dorrian Glenn spoke out 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 as of Tuesday night.

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

Damar Hamlin of the Buffalo Bills on the sideline during a preseason game against the Indianapolis Colts on Aug. 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, like, my nephew basically died on the field and they brought him back to life.”

Glenn told CNN the goal of the ventilator is to provide some relief for his nephew’s lungs, and the sedation is meant to help “his body … heal a lot faster” than if he were awake.

Glenn told CNN that Hamlin sustained some damage to his lungs, and doctors are working to get him breathing on his own again. He added to CNN that his nephew has been “flipped on his stomach” due to the blood on his lungs.

“It seems like he’s trending upwards in a positive way,” Glenn told CNN.

The night after the game, Hamlin stayed in the intensive care unit, according to an update from the Buffalo Bills from the afternoon of Jan. 3.

Damar Hamlin #3 of the Buffalo Bills is driven 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 driven 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 Jan. 2, 2023, in Cincinnati. Kevin Sabitus/Getty Images

After collapsing, Hamlin received CPR on the field for several minutes, according to the 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, described the moment as “unbelievable” in a TODAY segment aired Jan. 3. He recalled the “complete silence” before Hamlin was taken away in an ambulance.

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

“Guys stay down on the field all the time with injuries, but from the moment Damar hit the turf, it just seemed like something was different, (that) this situation was a lot more severe than normal,” Wood said.

While it’s common to see players go down with knee injuries, Wood said, witnessing a player requiring CPR on the field is “fairly unprecedented in the NFL” and left both teams “completely shaken.”

In their first statement since the incident, Hamlin’s family expressed their “sincere gratitude for the love and support shown to Damar during this challenging time” and added that they will release updates as soon as they have them.

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

What is commotio cordis?

Many medical professionals are discussing what might have caused Hamlin’s cardiac arrest. The exact cause has yet to be confirmed. “Assuming he’s a healthy athlete, one condition a lot of experts are looking at is something called commotio cordis,” Torres said.

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

Commotio cordis is Latin for “agitation of the heart,” Torres added, and it occurs when a person gets hit in the chest with a certain amount of force at a very specific time in the heart cycle, when the electricity is flowing from one side of the heart to the other. “Then that can trigger cardiac arrest. … It can be a lethal condition,” said Torres.

According to Dr. Khalid Aljabri, a Boston-based cardiologist, 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. Commotio cordis is mostly seen in athletes between the ages of 8 and 18 participating in sports with projectiles, according to the University of Connecticut’s Korey Stringer Institute, dedicated to preventing sudden death in sports.

“In the last couple of decades, we have recognized that you can have this non-penetrating blunt trauma to the chest. It happens in baseball (and) in hockey with hockey pucks,” NBC News medical contributor Dr. Natalie Azar told TODAY in a segment aired Jan. 3.

Can commotio cordis happen from a tackle?

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

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

In addition to the right timing, the impact has to happen in the right location, according to experts.

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

Can you survive commotio cordis?

When this condition occurs, it is 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 and get him resuscitated,” he said, adding that the paramedics springing into immediate action likely saved Hamlin’s life.

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

“Cardiac arrest is one of the most time-sensitive diseases in all of medicine. If CPR is not started right away, the chance of survival falls 10% to 15% per minute without CPR,” Dr. Benjamin Abella, director of the Center for Resuscitation Science at the University of Pennsylvania, tells TODAY.com.

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

Azar added: “Kudos to the EMTs and everyone there who (acted) on the spot.”

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

“What’s going on right now is he’s being sedated and … he has an artificial tube that’s helping him breathe,” Azar explained, adding that it will be critical for doctors to monitor Hamlin’s neurological state over the next 24 to 72 hours.

“The biggest concern when the heart stops is that your brain doesn’t get enough oxygen,” Azar said. “Brain activity stops very, very shortly after someone goes into cardiac arrest, within a couple of minutes.” She added that it’s unclear exactly how much time passed before Hamlin’s heartbeat was restored.

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

What is recovery like from commotio cordis?

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

“When you look across the United States, survival from the moment cardiac arrest strikes to leaving the hospital is less than 20%,” says Abella. This also depends on when the CPR was started, how well CPR was performed and the availability of automated external defibrillators (AEDs), he adds.

While it is very difficult to say what Hamlin’s recovery will look like, Abella says one thing for certain is that recovery will be slow — it could take days, if not weeks, to fully understand the extent of his injuries.

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

But there are glimmers of hope. “There are some well-known cases of athletes who made full recoveries after cardiac arrest — most notably, Fabrice Muamba in 2012 and Christian Eriksen (in 2021),” says Abella, adding that both players also had 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 the timing and the way it happened, (commotio cordis) is what most experts are thinking happened,” she explained.

According to Abella, professional athletes typically undergo extensive screenings and medical evaluation, so it would be surprising to find out now that Hamlin has an underlying heart condition or disorder. “(It) makes me think that 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 stage and we should learn more soon.

“Our fingers are crossed that he gets back to what he wants to do, playing football – which is possible – but more importantly that he gets back to a normal life,” Torres said.

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