Commotio cordis: Another cardiac arrest “sine materia”. The 1707 early report and interpretation by Giovanni Maria Lancis

Abstract

Sudden death by commotio cordis is rare. It is the consequence of a blunt trauma of the chest overlying the heart.

The mechanism is a cardiac arrest by ventricular fibrillation in the absence of grossly or microscopically apparent myocardial injury. It has been reproduced in animals. The first historical case was reported by Giovanni Maria Lancisi in his book "De Subitaneis Mortibus'' published in 1707. Sudden death occurred in a man receiving a powerful blow under the xiphoid cartilage. Lancisi advanced the hypothesis of acute heart failure by a diastolic stand still ("death in diastole'').