Damar Hamlin’s ‘heart attack’
The collapse of Damar Hamlin, Buffalo Bills Safety, after a tackle, has been described as a “heart attack,” but the reader should be warned that medical events are sometimes not described properly.
What everybody who was watching the game witnessed on Monday was Mr. Hamlin taking what looked like an ordinary hit to the chest. He and the other player both hit the ground, they both stood up, and then Hamlin collapsed in an instant. He received at least nine minutes of CPR on the field before an ambulance arrived to take him to the hospital, where he is still in critical condition.
Mr. Hamlin’s collapse was not caused by what most people think of as a “heart attack,” which is an interruption of blood supply to the heart muscle, usually because of blockage of one of the three major blood vessels of the heart.
In this case, the event was what is called commotio cordis, which is an abnormal life-threatening heart rhythm brought on by a blow to the front of the chest. The heartbeat disruption is ventricular (lower part of the heart muscle) fibrillation (rapid electrical activity) that produces a rapid discoordinated beating that doesn’t pump enough blood to the brain, at which point the person collapses.
Image: Damar Hamlin. YouTube screen grab.
In martial arts, the blow to the left chest over the heart is called “the touch of death.”
The defibrillator placed on Mr. Hamlin’s chest was the saving grace because it restored a heartbeat that pumped blood. He is now in an induced coma with the hope that it will protect not his heart but his brain.
Brain damage sets in after a few minutes of lack of circulation. Persons who have an “out of hospital cardiac arrest” and receive early CPR and defibrillation with ideal response times have a 25% survival to discharge from the hospital, all comers. A young healthy athlete is going to be on the more positive end of the curve for a chance of a good recovery.
The question of myocarditis increasing the chance of an abnormal sudden death rhythm is reasonable to consider since myocarditis is a widely reported complication of the COVID shot. At this point, the priority is actuating Mr. Hamlin’s safe and complete recovery.
It’s worth noting that Americans have found horrifying what happened to Mr. Hamlin and have reached out in typical American fashion: Mr. Hamlin’s charity project for kids is reported to have been bumped from a few thousand to more than a million.
John Dale Dunn MD JD is a retired emergency physician and inactive attorney in Brownwood, Texas.