transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-449-2022-9-1-5-11transmed-665Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINECommotio сordis как причина внезапной сердечной смерти, связанной с травмой грудной клеткиCommotio cordis as cause of sudden cardiac death associated with chest traumaСоколоваЛ. А.SokolovaL. A.

 д.м.н., профессор, ведущий научный сотрудник НИЛ профилактической кардиологии 

ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341 

 Dr. Sc., Professor, Leading Researcher, Department of Preventive Cardiology

 Akkuratova str., 2, Saint Petersburg, Russia, 197341 

sokolova_la@almazovcentre.ruhttps://orcid.org/0000-0003-4174-2708ГорловаИ. А.GorlovaI. A.

 к.м.н., научный сотрудник НИЛ профилактической кардиологии 

ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341 

 PhD, Reseacher Department of Preventive Cardiology 

 Akkuratova str., 2, Saint Petersburg, Russia, 197341 

gorlova_ia@almazovcentre.ruОмельченкоМ. Ю.OmelchenkoM. Yu.

 к.м.н., научный сотрудник НИЛ профилактической кардиологии 

ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341 

 PhD, researcher, Department of Preventive Cardiology 

 Akkuratova str., 2, Saint Petersburg, Russia, 197341 

omelchenko_myu@almazovcentre.ruhttps://orcid.org/0000-0002-6201-3638БондаренкоБ. Б.BondarenkoB. B.

 д.м.н., профессор, главный научный сотрудник НИЛ профилактической кардиологии 

ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341 

 Dr. Sc., Professor, Chief Researcher, Department of Preventive Cardiology 

 Akkuratova str., 2, Saint Petersburg, Russia, 197341 

bondarenko_bb@almazovcentre.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research Centre Russian Federation20220404202291511Copyright © Соколова Л.А., Горлова И.А., Омельченко М.Ю., Бондаренко Б.Б., 20222022Соколова Л.А., Горлова И.А., Омельченко М.Ю., Бондаренко Б.Б.Sokolova L.A., Gorlova I.A., Omelchenko M.Y., Bondarenko B.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/665

В литературном обзоре описывается редко встречающееся состояние сommotio cordis (СС) — фибрилляция желудочков (ФЖ), индуцированная обычно непреднамеренным тупым ударом в область передней грудной стенки при отсутствии структурного повреждения сердца. В основе развития ФЖ лежит совпадение времени закрытой травмы груди с травматически уязвимым периодом во время ранней реполяризации (так называемым «окном уязвимости»). Как правило, смерть наступает мгновенно или в ближайшие минуты после травмы. Возникновение СС чаще свойственно подросткам мужского пола и является второй ведущей причиной внезапной смерти у молодых спортсменов. Спасти пострадавшего с помощью кардиореспираторной реанимации или дефибрилляции удается только в 25–28 % случаев. Высокая смертность обусловлена тем, что пострадавшие часто не успевают получить немедленную врачебную помощь, прежде всего, в связи с отсутствием информированности населения о том, как важно избегать ударов в область сердца. Как превентивную меру во многих видах спорта усовершенствуют спортивное оборудование, применяют индивидуальные средства защиты грудной клетки. Наличие доступа к дефибрилляторам на спортивных мероприятиях, обучение персонала использованию дефибрилляторов и приемам сердечно-легочной реанимации может помочь улучшить выживаемость пострадавших от СС.

The review describes a rarely occurring state of commotio cordis (CC) — ventricular fibrillation (VF), associated with unintentional blunt impact on the anterior thoracic wall in the absence of structural damage to the heart. The development of VF is based on the coincidence of the time of a closed breast trauma with a vulnerable period during early repolarization (the so-called "vulnerability window"). More often, death occurs instantly or in the coming minutes of a post-traumatic period. CC is more common in male adolescents and seems to be the second leading cause of sudden death in young athletes. It is possible to save the victim with cardiorespiratory resuscitation or defibrillation only in 25–28 % of cases. High mortality is explained by the fact that victims often do not have time to receive immediate medical care. It is necessary to inform the population, medical community and athletes about importance to avoid hitting the heart. As a preventive measure in some sports, chest protectors are used. Information about the potential danger of blows to the heart area should be provided to the attention of athletes involved, since even an unintentional mild blow can provoke a life-threatening arrhythmia. Having access to defibrillators at sporting events, teaching people to use them and to realize the cardio-pulmonary resuscitation measures can improve the survival of the CC victims.

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The authors declare that there are no conflicts of interest present.