What led to the collapse of Damar Hamlin of the Buffalo Bills?

A potential cause of the collapse and cardiac arrest of Buffalo Bills safety Damar Hamlin – seen in real time by millions of ‘Monday Night Football’ viewers – was immediately recognized by cardiac experts who were also watching the game.

“I knew exactly what was going on,” said Dr. Nahush Mokadam, director of the division of cardiac surgery at Ohio State University Wexner Medical Center. “The way he first stood up and then fell down…that’s not what a concussion would look like.”

In a statement released Tuesday, Hamlin’s family thanked first responders and medical professionals at the University of Cincinnati Medical Center, where he is being treated.

“On behalf of our family, we want to express our sincere gratitude for the love and support extended to Damar during this difficult time,” the family wrote.

There was no briefing scheduled at the hospital on Tuesday afternoon, NBC News confirmed.

Neither Mokadam nor any other doctors interviewed for this story are involved in Hamlin’s treatment. In a statement, the Invoices said only that Hamlin has suffered cardiac arrest, when the heart stops beating properly and he is in critical condition.

It was during the first quarter of Monday night’s game between the Invoices and the Cincinnati Bengals when Hamlin, 24, tackled a Bengals receiver, who collided with his chest. Hamlin got up after the tackle but immediately collapsed.

Although there are several potential causes for Hamlin’s cardiac arrest, cardiologists have suggested that a rare phenomenon called “commotio cordis” was to blame.

Damar Hamlin at Orchard Park, NY in 2021. File Joshua Bessex / AP

In such cases, “there is nothing wrong with the heart,” said Dr. Hari Tandri, director of the cardiac arrhythmia program at Vanderbilt University Medical Center in Nashville, Tennessee. A healthy heart, when struck with blunt force at a specific time, Tandri said, can launch into an abnormal and potentially fatal rhythm.

A spokesperson for the American Heart Association, Dr Comilla Sasson, an emergency physician in Denver, said: “It’s not about the force of the blow. It’s actually about when the blow happens. .”

Normally, the heart pumps oxygen-rich blood throughout the body about every second. There is a rhythm to the process, keeping the blood flowing at a healthy pace. But every time the heart beats, there’s a tiny moment – less than a fifth of a second – that makes it vulnerable to the force of a projectile, like a hockey puck or a baseball, which can lead to a chaotic and life-threatening situation. heartbeat.

It is at this exact moment, experts say, that a blow to the chest in the right place can cause cardiac arrest in an otherwise healthy person. The heart’s electrical system malfunctions and the heartbeat goes out of whack.

The seconds after such an injury are critical to the patient’s survival, Sasson said.

“For every minute you haven’t performed CPR, your chance of survival decreases by about 10%,” she said. In Hamlin’s case, sideline medical staff rushed to perform CPR until he was stable enough to be taken by ambulance for further treatment.

Commotio cordis is thought to occur about 15 to 20 times a year in the United States, mostly in teenagers playing sports like baseball, hockey or lacrosse, said Dr. Mark Link, a cardiologist at Southwestern Medical Center in Washington. ‘University of Texas.

It’s even rarer in people over 20 because the ribs harden with age and are better able to protect against blunt trauma, said Link, a commotio cordis expert who is a clinical cardiac electrophysiologist. specializing in heart rhythm problems.

NFL players undergo health screenings, which can include heart scans, to identify potential health issues long before entering the field.

That suggests an underlying heart condition is unlikely to go unnoticed, Mokadam said.

But there are several other reasons why a person may go into cardiac arrest. Sometimes a blood vessel in the heart muscle swells and bursts.

Mokadam said it’s unlikely that happened in Hamlin’s case. “If it was an aneurysm that had burst, he would have needed emergency open-heart surgery,” he said. “CPR and an AED won’t fix the problem.” (AED refers to a form of defibrillation therapy.)

And after?

The 24 hours after such an injury are critical, doctors say. Doctors are most likely carrying out a number of tests to make sure there are no underlying heart issues that could have led to Hamlin’s collapse or the injuries he sustained after Monday’s collision evening. They might include an ultrasound of the heart, a cardiac MRI, and CT scans of the brain.

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