Recent research has revealed that children who play active sports like baseball, hockey, football or lacrosse risk sudden death from a hard blow to the chest although they may be clad in protective gear.
The study presented at the annual American Heart Association meeting in Chicago revealed that commercially available equipment may not be protective enough for young athletes if the chest is hit in a manner that triggers an irregular heartbeat called ventricular fibrillation.
"If the blow occurs directly over the heart at a particular time in the heart's cycle, the results can be catastrophic," said the report's lead author, Dr. Barry Maron, director of the Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation.
As a result the electrical activity of the heart becomes disordered and its lower chambers contract in a rapid, unsynchronized way causing little or no blood to be pumped. The result of this is collapse and sudden death unless immediate medical help is provided.
The study showed that such a rare but tragic blow can come from a ball, bat, hockey stick, puck or hard contact with another person.
47% of the 182 cases of ventricular fibrillation tracked by Maron since 1995 occurred during practice or competition in organized sports. He reported that thirty-nine percent of the children of average age of 15 years suffered fatal chest blows despite the presence of protective equipment.
The remaining 53 percent occurred during recreational sports or normal activities around the home.
There were 14 hockey players, 10 football players, six lacrosse players and three baseball catchers among these athletes. In 23 of the deaths, padding did not cover the chest at the time of the blows, and 10 deaths occurred when projectiles directly struck the chest protector.
The athletes were dressed in standard, commercially available chest barriers made of polymer foam covered by fabric or a hard shell.
In addition research conducted at the New England Medical Center and Tufts University School of Medicine in Boston revealed that ventricular fibrillation could be caused by a baseball moving 30 mph (48 kph), but only if impact occurred directly over the heart during a 20-millisecond window when the lower heart chambers are relaxed.
Maron said that these findings indicate a need for better chest protection to make the athletic field safer for young participants.
He added that those involved with youth sports also must be taught to recognize when a child has suffered the potentially deadly heart rhythm -- known as commotio cordis -- so that prompt resuscitation and defibrillation can occur.
He said, "Hopefully, these data will represent a stimulus for developing a truly effective chest barrier that will be absolutely protective against the risk of these commotio cordis catastrophes."