A Case of Commotio Cordis Caused by Horse Kick

Abstract

Sudden death in adults after non-penetrating chest blows are rare cases which are successfully resuscitated. Commotio cordis is the most described report during sporting activities in the youth. There have been very few reports of commotio cordis caused by other traumas. They endure a low survival rate. We reported a rare case of commotio cordis caused by a horse kick injury in a middle-aged male, who was successfully resuscitated and discharged without any neurological sequelae. This case can be classified as commotio cordis as the ventricular fibrillation (VF) had developed immediately after chest injury. The patient was a 46 year-old male who suffered a severe horse kick impact to the chest while examining the horse. He had no history of cardiac disease or other system diseases. The patient was transported to our hospital in a private car. He arrived at the emergency room within 10 minutes of the accident. There was no basic life support until he arrived. Evidence of ventricular fibrillattion led the doctor to carry out immediate defibrillation with a biphasic defibrillator and started cardiopulmonary resuscitation. We performed endotracheal intubation. Return of the spontaneous circulation was restored within 10 minutes of CPR, and establishment of normal sinus rhythm was confirmed. The patient was immediately examined for internal organ injuries that might cause death. General physical examination determined an 8 cm in length abrasion in the chest wall resulting from blunt trauma, and computerized tomography of the chest showed pulmonary contusion on the left lung. There wasn’t any pneumothorax, hemothorax or cardiac tamponade in the imaging of the mediastinum. The patient was transported to our hospital’s Intensive Care Unit. On arrival, he was hemodynamically stable and image studies were clear. The vital signs were stable (blood pressure: 125/77 mmHg, heart rate: 88 bpm, respiratory rate: 24 bpm, body temperature: 36.0 c). Glasgow Coma Scale score was 3 (E1 V1 M1). Serum CKMB and Troponin I levels were normal. No evidence of any other critical injury was detected. The patient remained in the ICU for two days. During the clinical course, the patient remained hemodynamically stable and there was no recurrence of arrhythmia. On day 2, he had woken up and extubation had been performed by the ICU doctors. He was able to communicate and asked for discharge. Three days after being accepted to the intensive care unit, he was discharged on his request.