Board of Certification for the Athletic Trainer (BOC) Practice Test

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What is the most likely cause of Commotio Cordis?

Blunt trauma to the chest
Fluid accumulation around the heart
Heart puncture by a rib
Hypertrophic cardiomyopathy

The correct answer is: Blunt trauma to the chest

Commotio Cordis is typically caused by a specific type of blunt trauma to the chest that results in a disruption of the heart's electrical activity, leading to sudden cardiac arrest. This condition often occurs when a person's chest is struck by a projectile, such as a baseball or hockey puck, at a precise moment in the heart's electrical cycle. It is important to note that the impact does not have to be particularly forceful; rather, the timing and location of the blunt force are critical. Fluid accumulation around the heart, a heart puncture by a rib, and hypertrophic cardiomyopathy are associated with other cardiac conditions but do not specifically lead to the sudden electrical disturbance characteristic of Commotio Cordis. The mechanism of injury in Commotio Cordis is unique; it is the momentary impact causing a fatal heart rhythm disturbance, rather than structural damage to the heart itself. Understanding this mechanism is essential for recognizing and preventing Commotio Cordis during sports and activities where chest impacts might occur.