Spitaler Philipp, Stühlinger Markus, Adukauskaite Agne, Bauer Axel, Dichtl Wolfgang
Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria.
J Clin Med. 2023 Mar 16;12(6):2323. doi: 10.3390/jcm12062323.
(1) Background: Commotio cordis, caused by objects being directly delivered to the chest, may cause cardiac arrest in young athletes, even without identifiable structural damage to the sternum, ribs or heart itself. Its prevention and management often remain suboptimal, resulting in dismal outcomes. (2) Case summary: A 32-year semi-professional goalkeeper suffered from a non-penetrating blunt thoracic trauma after being struck by a high-velocity shot during a regional league soccer game. He immediately lost consciousness, collapsed, and was successfully resuscitated through early defibrillation of ventricular fibrillation. After an uneventful follow-up for approximately 6 years, recurrent episodes of ventricular tachycardia occurred, which could ultimately only be prevented by epicardial ablation. (3) Conclusion: Very late recurrences of ventricular tachyarrhythmias may occur after ventricular fibrillation due to blunt chest trauma, even in the primary absence of evident structural myocardial damage.
（1）背景：心脏震荡由物体直接撞击胸部引起，可导致年轻运动员心脏骤停，即使胸骨、肋骨或心脏本身无明显结构损伤。其预防和治疗往往仍不尽人意，导致预后不佳。（2）病例摘要：一名32岁的半职业守门员在一场地区联赛足球比赛中被高速射门击中后，遭受了非穿透性钝性胸部创伤。他立即失去意识，倒地，通过早期除颤成功复苏室颤。经过约6年的平稳随访后，出现了室性心动过速复发，最终只能通过心外膜消融来预防。（3）结论：钝性胸部创伤导致室颤后，即使最初没有明显的结构性心肌损伤，也可能发生非常晚的室性快速性心律失常复发。
