Commotio cordis differential diagnosis

Commotio cordis should be distinguished from cardiac contusion, which occurs when a blunt strike to the chest damages the structural heart structures. the differential diagnosis of commotio cordis includes other causes of sudden cardiac death during sport participation, such as familial hypertrophic cardiomyopathy, myocarditis, dilated cardiomyopathy, long-QT syndrome, Brugada syndrome, Wolf-Parkinson-White syndrome, Marfan syndrome, aortic valve stenosis, mitral valve prolapse, coronary artery disease, asthma, heat stroke, drug abuse, and a ruptured cerebral artery. It is important to consider the possibility of intentional acts of violence causing commotio cordis.

Commotio cordis should be distinguished from a condition called a cardiac contusion, which occurs when a blunt strike to the chest damages the structural heart structures. Motor vehicle accidents are an example of such a case. The differential diagnosis of commotio cordis includes other causes of sudden cardiac death during sport participation, such as^[1][2]:

• Familial hypertrophic cardiomyopathy
• Myocarditis
• Dilated cardiomyopathy
• Long-QT syndrome
• Coronary artery anomalies
• Brugada syndrome
• Wolf-Parkinson-White syndrome
• Marfan syndrome
• Aortic valve stenosis
• Mitral valve prolapse
• Asthma
• Heat stroke
• Drug abuse
• Ruptured cerebral artery

In addition to accidental causes, commotio cordis can also be caused by intentional acts of violence. There have been reported cases of homicidal commotio cordis caused by domestic violence^[3].

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