Which scenario is classic for commotio cordis?

• A. Adolescent struck in the chest during athletic activity
• B. Severe allergic reaction without chest impact
• C. Myocardial infarction
• D. Pneumothorax

Answer: (A)

Commotio cordis is a sudden cardiac arrest caused by a blunt, non-penetrating chest impact, usually during athletic activity in a structurally normal heart. The classic setting is an adolescent athlete who is struck in the chest during sports, such as by a ball, viruses, or other projectiles, at a very vulnerable moment in the heart’s electrical cycle, typically around the upstroke of the T wave. That timing can provoke ventricular fibrillation, leading to abrupt collapse unless defibrillation is delivered promptly. The other options describe conditions without a chest impact or with different pathophysiology—an allergic reaction without chest trauma, a myocardial infarction, or a pneumothorax—so they don’t fit the characteristic mechanism of commotio cordis.