Possible mechanisms for<unk>  include direct, indirect, bidirectional, deceleration, blast, crush, concussive, or combined. A direct injury is the most common and occurs most likely near the end of diastole, during ventricular filling. Indirect injury results from increased preload on the heart secondary to spikes in venous circulation which can then lead to rupture of the heart. Bidirectional injuries are a result of compressive forces on the heart by both the spine and the sternum. Deceleration injuries occur when the heart is forcibly torn from its attachments, thereby leading to tears of the muscle and arteries. Commotio cordis is a condition seen in young, male athletes that results from<unk> , and leads to sudden<unk>  death within the context of benign changes of the heart on autopsy and no preexisting conditions. The impact of<unk>  in this condition likely puts the heart in ventricular fibrillation, thereby resulting in death. Structural and electrical disturbances are typical of<unk> . Examples of structural injuries include intramural hematomas (which are benign and self-limiting in most cases), papillary muscle rupture, and septal injuries. Common electrical disturbances include premature ventricular contraction and transient bundle branch blocks. It is important for the clinician to monitor the patient’s EKG and conduct a thorough cardiovascular exam to evaluate for murmurs and abnormal heart sounds in these cases.
Blunt cardiac injury
Traumatic cardiac arrest
Lightning strike
Spinal shock
Neurogenic shock
Distributive shock
Reperfusion injury
Ischemic cascade