What Caused Damar Hamlin's Cardiac Arrest?

It has been less than two weeks since Buffalo Bills safety Damar Hamlin suffered cardiac arrest right after he made a tackle in a Monday night football game versus the Cincinnati Bengals.

20 minutes of CPR and other emergency measures were administered on the field before Hamlin was put in an ambulance and transported to the University of Cincinnati Medical Center.

From all reports, Hamlin has made a remarkable recovery considering what appeared to be dire prospects on the field when he heart was not beating.

Hamlin was recently released from the Buffalo hospital that he was transferred to after his initial treatment in Cincinnati and is now recovering and and undergoing rehab at his home.

It is fantastic news all around.

However, the question still remains as what caused Hamlin to suffer cardiac arrest?

In thousands of NFL games with millions of tackles in over 100 years of play and we have never seen anything like this. 

Is there something that can be learned from this to avoid a similar result in the future?

I was watching the game live and there is no doubt that Hamlin suffered a strong blow to his chest area.

Cincinnati Bengals receiver Tee Higgins lowered his shoulder as Hamlin came up to tackle him and you could see him clearly buckle up with force of the blow in real time. 

Here are a couple of images of the hit. Notice that the helmet, which would have magnified the force of the blow, is not hitting the chest area.

Credit: wfft.com

Credit: Getty Images via The Daily Mail

I have seen some people say it was an ordinary hit in the NFL. I didn't see it that way when I was watching the game. It was a very forceful blow by Higgins on Hamlin. I cringed when I saw it.

Seeing Hamlin get up and then collapse I immediately thought that the young athlete might have suffered what is called Commotio Cordis.

This is how WebMD describes the condition.

Commotio cordis is a medical condition that happens when your heart suddenly stops beating (known as cardiac arrest). It usually happens when there's a serious blow or injury to the chest that causes abnormal electrical activity in the heart.

The condition is rare. It's most commonly seen among athletes ages 8-18 who play contact sports like football or martial arts. It can also happen in sports that involve blunt objects like baseballs, hockey pucks, or lacrosse balls.

The most common cause is an impact to the left side of your chest during a sports activity. The impact gives a sudden jolt to the heart muscle. This can cause the heart to have a sudden, irregular, and fast pattern of heartbeats (ventricular fibrillation) and effectively stop beating.

Commotio cordis is an extremely dangerous condition and can lead to death. It's the second leading cause of sudden cardiac death among athletes. If it occurs, CPR and medical attention are needed right away to restore the heartbeat as soon as possible or the odds of survival are very low.

Boys are more likely than girls or adults to experience commotio cordis. In fact, over 9 out of 10 reported cases occur in boys.

Experts believe that a thinner chest wall among young children compared to adults increases the odds of commotio cordis.

I was familiar with Commotio Cordis as I had a son play both high school and college lacrosse and knew about the sad situations where lacrosse players had died after taking a fast traveling lacrosse ball to their chest causing cardiac arrest.

Two that I particularly remember were a University of Massachusetts lacrosse player in 1999 and an athlete from Cornell University who died in 2004 after taking a lacrosse ball to the chest.

The UMass player was Eric Sopracasa who was 21.

Source: https://www.baltimoresun.com/news/bs-xpm-1999-05-07-9905070262-story.html

Eric Sopracasa, a junior midfielder at the University of Massachusetts, is one of only two lacrosse players known to have died after being struck in the chest with a ball, a leading cardiac researcher said.

Sopracasa, from Farmingville, N.Y., collapsed after being hit by a ball in practice Wednesday, said UMass officials. He was later pronounced dead at Cooley Dickinson Hospital. The cause of death is unknown, but the circumstances are similar to those of several young athletes who have died after being struck in the chest with a baseball or hockey puck.

 

The Cornell player was George Boiardi who was age 22.

George Boiardi, a Cornell University senior student, was struck in the chest with a lacrosse ball late in the fourth quarter of a game against Binghamton University last night (March 17) at Cornell's Schoellkopf Field. He collapsed, and medical personnel tried to revive him on the field. He was rushed to Cayuga Medical Center, where he was pronounced dead at 6:44 p.m.

Both of these deaths stood out to me because they came at a time that my son was playing lacrosse where the ball can be traveling at speeds of over 90 mph with college players.

It is a risk you don't disregard when you are a father.

Was Damar Hamlin a victim of Commotio Cordis?

That was my first reaction.

However, is that what really caused Damar Hamlin's cardiac arrest?

There has been nothing stated yet from the doctors who treated Hamlin.

Could Hamlin have had some type of undetected congenital heart defect that contributed to his cardiac arrest?

Some have questioned whether the Covid vaccine that all NFL players were pressured into taking might be responsible. It appears that last year Hamlin was fully vaccinated as were all Buffalo players save for two (reports are that Josh Allen and Cole Beasley refused the vaccine last year).  I have not seen any reports this year on booster uptake with NFL players although in December, 2021 it was league policy for all players, coaches and staffs to get a booster dose.

The CDC has stated that myocarditis or pericarditis is a potential side effect of the Covid shots especially with young men under age 40. Those between age 12 and 24 have the highest risk.

However, the CDC also states that cases of myocarditis or pericarditis caused by the vaccine are very rare and most resolve over time with no long term effects.

Dr. Tony Fauci was quick to take to the airwaves and immediately state that it was clear that Hamlin had taken a severe blow to his chest area and it is known that this can cause a traumatic injury to the heart. He dismissed as a "conspiracy theory" any suggestion that Hamlin's cardiac arrest could be due to the mRNA vaccine.

I fully understand why the public health establishment and the NFL want the vaccine to be ruled out as a possible cause of Hamlin's injury.

It would not be very good PR for people like Fauci in the public health arena if Hamlin's injury was somehow found to be associated with the vaccine nor would it be good for the NFL who so zealously promoted the vaccines to its players.

I am not a doctor so I will wait for medical professionals who have treated Hamlin and run tests on him to see their conclusions.

However, since that first night when my initial conclusion was that it was due to Commotio Cordis, further research I have done has raised some doubts in my mind on what was the cause of Hamlin's heart issue.

First, cases of Commotio Cordis are most likely in those age 8-18. This is because they have thinner chest walls protecting the heart. Hamlin was 24. It is true that the two lacrosse cases I cited above were 21 and 22 but Hamlin was older still and being a professional football player likely had even more chest musculature than the college lacrosse players.

Second, almost all cases of Commotio Cordis involve a serious blow directly to the heart area in a compact, forceful way such as delivered by a baseball or lacrosse ball. The energy is concentrated in a small area and is not spread over the chest.

Hamlin took a shoulder to his chest. That would disperse the force across the chest much more than being hit by a ball. It is true that the shoulder pad of Higgins could have somehow magnified the blow and it might have made more contact directly with the heart area.

However, the other factor at play here is the force of the blow due to the speed of the object hitting the chest.

A baseball or lacrosse ball hitting an object at 90 mph delivers an enormous amount of concentrated force.

Tee Higgins is 6'4'' and 218 pounds. At the NFL Combine he ran a 4.59 40 yard dash. That translates to a speed of 17.8 mph.

Why is this relevant?

Energy created in a collision is generally a product of the square of the velocity of the impact.

The speed of a thrown ball is much greater than the speed of any human being.

These tweets by Dr. Venk Murthy who is a cardiologist and also holds a PhD in Biophysics from Johns Hopkins was thought provoking for me.

 

It is an additional perspective I was not aware of when I first considered that Commotio Cordis was the likely cause of Hamlin's collapse.

Third, I find it interesting that almost two weeks into this, no conclusions have been announced by the doctors treating Hamlin as to what caused Hamlin's cardiac arrest. 

In the environment we have been living in I would think there would be pressure to declare it was Commotio Cordis and bury any notion of vaccine involvement.

I hope that this is because they want to be exceedingly careful in any conclusions they render in this case. Is this is a sign where truth may once again be valued more than the narrative? I hope so.

My fear is we may never be given an answer.

Or it will not be the full truth.

However, it seems as if we are seeing an abnormal number of what appear to be healthy, young people suddenly developing heart or vascular related conditions.

Can anyone explain why this is happening?

Source: https://twitter.com/RealWayneRoot/status/1612313683178446848/photo/1

Source: https://www.cbsnews.com/news/hunter-brown-dies-age-21-air-force-academy-football-player-medical-emergency/

All of these incidents have been reported in the last couple of months.

Are all of these just weird coincidences?

Is this just because we have an amplified news cycle powered by social media?

Or is there something more to all of this?

Let's hope we get answers we can rely on.

For Damar Hamlin...and everybody else.