RICHMOND, Va. -- Medical experts still don't know what exactly caused Buffalo Bills Safety Damar Hamlin to suffer cardiac arrest and collapse on the field at Paycor Stadium Monday night in a game against the Cincinnati Bengals.
Cardiologists and electrophysiologists at VCU Health and UVA Health are speculating the cause to be "Commotio Cordis" when Hamlin was hit in the chest during a tackle.
After the play, Hamlin stood up, then collapsed, sending a shock to those on and off the field, including VCU Cardiologist Dr. Jeremy Turlington.
“I think everybody’s working diagnosis is, if you watch, he made that tackle and the other player lowered his shoulder into his chest and then he stood up, then when he collapsed, that’s when you go, ‘Oh, something different is going on, you know, it’s not the typical head injury or somebody got the wind knocked out of them’ kind of thing," Turlington said.
Commotio Cordis, Latin for "agitation of the heart," occurs when a strong blow to the area directly over the heart at a critical time during the cycle of a heartbeat.
"The impact on the chest really has to happen at this, really, right exact millisecond when the heart is getting ready to fire again. And it's not quite ready there. So when the impact hits, it throws them into this fatal abnormal heart rhythm called 'ventricular fibrillation," Turlington explained.
Turlington said according to a registry tracking cases of Commotio Cordis, only 10 to 20 cases are reported annually.
"As a cardiac intensivist, we treat cardiac arrest daily, you know, that we see very commonly. This form of cardiac arrest is exceedingly rare, and in my time here, over the past 13 years, I've never seen this happen before," he said.
Dr. Pam Mason, an electrophysiologist who specializes in arrhythmias and cardiac arrest, said medics prepared to react in seconds made the difference. According to CNN, medics with the Buffalo Bills team were treating Hamlin in about 10 seconds and an ambulance team was brought onto the field in under five minutes. Hamlin received CPR and had his heartbeat restored while on the field.
"It's critical to have on the sidelines for professional sporting events, trained personnel, which they certainly had. People who understand CPR and AED, how to perform even more advanced therapies, having a defibrillator on the sidelines," Mason said.
Both Mason and Turlington said CPR certification and AED training is easy and accessible for anyone, no matter if they have any medical experience or not.
"We'd really like everybody to be trained on CPR. What they were doing on the sideline, initially, every member of our community can provide too, whether it's an athlete or an older patient," Mason said.
"For lack of a better term, he died on the field last night and I think people need to hear that. With cardiac arrest, he really did die and the heroic measures of this training staff and everybody at the Bengals' stadium to get there as quickly and do everything? They saved his life," Turlington said.
The most recent information released by the Buffalo Bills said Hamlin is sedated and in critical condition at the University of Cincinnati Medical Center.
Turlington and Mason said they expect specialists will monitor his neurological state because he likely lost oxygen to his brain while suffering cardiac arrest. Turlington said he expects a series of tests and screenings to determine an exact cause, which could take several days.
The two said while some athletes can wear a protective chest covering while playing contact sports, there's little data regarding chest protection to prevent something like Commotio Cordis.
"Certainly, the padding that professional sports and more amateur sports athletes wear for things like men's lacrosse, football, all of that padding can be assistive in helping prevent these events. But unfortunately, you know, they are sort of random events that can occasionally happen despite that, as we just saw," Mason said.
