A shocking Monday Night Football injury is more often seen in baseball or hockey, Pa. the doctors say

Two Pennsylvania doctors say the injury that sent an NFL player into cardiac arrest last night on Monday Night Football may well be the result of a perfectly but unfortunately timed blow to the chest.

Doctors who each saw the play or replay believe Buffalo Bills’ Damar Hamlin most likely suffered commotio cordis.

The condition is typically caused by blunt trauma to the chest, which essentially sends the heart into dysfunction. It causes sudden cardiac arrest, said Dr. Jessica Butts, a sports medicine physician at Penn State Health Milton S. Hershey Medical Center.

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A Pennsylvania sports cardiologist, who could not be named because of the NFL connection, also said commotio cordis seems the most likely cause. The injury resulted in Hamlin receiving about 20 minutes of CPR on the field before being taken by ambulance to the hospital, where he was listed in critical condition this morning.

The cardiologist said that commotio cordis can occur when the chest is hit hard and the sternum is hit at just the right time.

Doctors said that for cardiac arrhythmia and cardiac arrest to occur, the stroke must occur during a small period of the heart’s cycle.

Butts said he was watching when the injury occurred in the first quarter of the game between the Bills and the Bengals.

He said commotio cordis came to mind because Hamlin appeared to have been hit in the chest and also because he stood up briefly before collapsing.

It’s not uncommon for commotio cordis collapse to occur after a short delay from the actual collision, he said.

He said injuries are rarely seen in football. Rather, it is most common among young men who participate in sports such as baseball or hockey after being hit by a ball or puck, or as a result of a blow received in a sport such as boxing or martial arts.

The survival rate is only about 15 percent, he said.

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Hamlin, a 24-year-old Pittsburgh native, is the Bills’ starting safety.

He was injured after making contact with a Bengals receiver whose shoulder pad appeared to hit him in the chest.

He was on the field for 19 minutes while medical personnel gave him life-saving treatment, including CPR. According to the Associated Press, the crew also used an automated external defibrillator. AEDs are commonly used in a heart attack to restore its rhythm. They have the ability to prevent them from delivering a shock if there is not a rhythm problem, such as if the person is having a heart attack.

The game was suspended due to an injury.

As of this morning, Hamlin was unconscious and sedated while on a ventilator.

The cardiologist said it would be ideal for someone to wake up immediately after restoring a normal heart rhythm with an AED. However, he does not consider it unusual or necessarily ominous that Hamlin is sedated and on a ventilator.

He said its possible doctors may have lowered Hamlins’ body temperature as part of a treatment that can help the brain and heart recover from a period without oxygen. This would usually take 24 to 48 hours before the sedation wears off and doctors try to wean the person off the ventilator.

Doctors stress that they can only speculate about what happened to Hamlin, and more tests and information are needed to understand his injury and prognosis.

They said there are other conditions that could have disrupted Hamlin’s heart rhythm and caused the cardiac arrest. The most likely of these, however, are the conditions normally seen in tryouts and screenings given to NFL players.

The cardiologist said Hamlin’s young age and exceptional physical condition may bode well for his recovery.

However, he said that even if Hamlin recovers and tests reveal no structural damage to his heart, he would likely be advised not to participate in contact sports.

Both doctors said the injury underscores the value of ordinary people knowing how to perform CPR and use an AED. They emphasized that cardiac arrhythmias leading to cardiac arrest are relatively common, often in public spaces, and the survival rate is much higher when someone immediately uses an AED and performs CPR.

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