Link M S, Wang P J, Maron B J, Estes N A
New England Medical Center, NEMC Box #197, 750 Washington Street, Boston, MA 02111, USA.
Cardiol Rev. 1999 Sep-Oct;7(5):265-9. doi: 10.1097/00045415-199909000-00010.
Although thought to be rare, sudden deaths caused by nonpenetrating chest wall impact in the absence of structural injury to the ribs, sternum, and heart (commotio cordis) are reported with increasing frequency. This phenomenon is described in individuals when they are struck by relatively innocent blows to the chest wall. Young male athletes aged 5 to 18 years are particularly at risk for this catastrophe. It has been described after blows to the chest from baseballs, softballs, hockey pucks, and other objects. Death is usually instantaneous, and successful resuscitation is uncommon. A recently reported experimental model provides clues to the mechanisms and inferences for the prevention and treatment of this devastating condition. This swine model shows that a) ventricular fibrillation results from low-energy chest wall impacts during a vulnerable period of repolarization, b) the risk of this event can be decreased with softer-than-standard baseballs, and c) prompt defibrillation is crucial for resuscitation to be successful.
尽管被认为较为罕见，但因胸壁非穿透性撞击导致的猝死报告频率却在不断增加，而肋骨、胸骨和心脏并无结构损伤（心脏震荡）。这种现象在个体受到相对无害的胸壁打击时会出现。5至18岁的年轻男性运动员尤其容易遭遇这种灾难。在被棒球、垒球、曲棍球 puck 及其他物体击中胸部后曾有过相关描述。死亡通常是瞬间发生的，成功复苏并不常见。最近报道的一个实验模型为这种毁灭性病症的发病机制以及预防和治疗推断提供了线索。这个猪模型表明：a）在复极化的易损期，低能量胸壁撞击会导致心室颤动；b）使用比标准棒球更软的球可降低此事件的风险；c）及时除颤对于复苏成功至关重要。 （注：原文中“hockey pucks”常见释义为“曲棍球冰球”，这里结合语境，“puck”直译为“圆盘状物”，整体表述“曲棍球 puck”更符合语境，因不确定具体所指，保留英文未翻译，你可根据实际情况调整。）
