Cardiac Conditions Associated with Sudden Death

Commotio Cordis Sounds

This is an example of commotio cordis as heard at the mitral valve area.

This condition is caused by blunt force trauma to the chest such as a baseball batter being hit in the chest by a pitch. Severe damage to the right and left ventricles and mitral and tricuspid valves may result.

In the example we are showing, the trauma is limited to the mitral valve leaflets. Rupture of a chordae tendinae has occurred resulting in a systolic murmur.

The first half of the murmur is rectangular. It is followed by a decrescendo late systolic component. This is caused by rapid filling of the left atrium due to torrential mitral regurgitation.

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The recommended auscultation position for the stethoscope is the Mitral position. For this sound, use stethoscope's Diaphragm.

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The recommended patient position is Supine

Phonocardiogram

This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons

1	Hypertrophic Cardiomyopathy
2	Aortic Stenosis - Severe 2
3	Arrhythmogenic RV Dysplasia
4	Mitral Valve Prolapse (Click with Late Systolic Murmur)
5	Myocarditis
6	Commotio Cordis
7	Ebstein's Anomaly

Practice Drill

Listening Tips
A synopsis of important sound features and timing for this abnormality.
Systole: Rectangular murmur in first half of systole then decrescendo.

CaseID	116
CourseID	30
CourseCaseOrder	6
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