Jan. 3, 2023, 3:33 PM EST / Updated Jan. 5, 2023, 12:49 PM EST
By Erika Edwards
Damar Hamlin injury update Jan 06, 2023: Buffalo Bills player awake and conscious,
asks ‘did we win?’ – ABC7 Chicago
A potential cause of Buffalo Bills safety Damar Hamlin’s jarring collapse and cardiac arrest — witnessed in real time by millions of viewers of “Monday Night Football” — was immediately recognized by heart experts who also happened to be watching the game.
“I knew exactly what was going on,” said Dr. Nahush Mokadam, the division director of cardiac surgery at Ohio State University Wexner Medical Center. “The way he first stood up and then collapsed … it’s not what a concussion would look like.”
On Thursday morning, the Buffalo Bills tweeted that Hamlin’s brain function appears to be in good condition, following days of uncertainty and worry after the player’s cardiac arrest during Monday night’s game against the Cincinnati Bengals. “Damar has shown remarkable improvement over the past 24 hours,” the Bills said on Twitter. “While still critically ill, he has demonstrated that he appears to be neurologically intact.”
It was during the first quarter of Monday night’s game when Hamlin, 24, tackled a Bengals receiver whose shoulder appeared to collide with Hamlin’s chest. Hamlin stood up after the tackle but collapsed seconds later. None of the physicians interviewed for this story is involved in Hamlin’s treatment, although a statement from the Bills said only that Hamlin suffered a cardiac arrest, when the heart stops beating properly.
While there are several potential causes for Hamlin’s cardiac arrest, cardiologists suggested that a rare phenomenon called “commotio cordis” was to blame. In such cases, “there is nothing wrong with the heart,” said Dr. Hari Tandri, the director of the cardiac arrhythmia program at Vanderbilt University Medical Center in Nashville, Tennessee.
A healthy heart, when hit with blunt force at a specific time, Tandri said, can launch into an abnormal and potentially deadly rhythm.
A spokesperson for the American Heart Association, Dr. Comilla Sasson, an emergency medicine physician in Denver, said: “It’s not about how hard of a hit it was. It’s actually about the timing of when the blow happens.” Normally, the heart pumps oxygen-rich blood throughout the body about every second. There is a rhythm to the process, keeping the blood flowing at a healthy pace.
But every time the heart beats, there is a tiny moment — less than a fifth of a second — that makes it vulnerable to the force of a projectile, such as a hockey puck or a baseball, that can lead to a chaotic and potentially deadly heart rhythm. It is in this exact moment, experts say, that a blow to the chest in the exact right place can launch an otherwise healthy person into cardiac arrest. The heart’s electrical system malfunctions, and the heartbeat rhythm goes haywire.
Seconds after such an injury are critical to the patient’s survival, Sasson said.
“For every one minute that you don’t have CPR performed, your chances of survival
go down by about 10%,” she said. In Hamlin’s case, medical personnel on the sidelines rushed in to perform CPR until he was stable enough to be taken by ambulance for
further treatment.
What could have caused Damar Hamlin’s cardiac arrest? – Bing video
Buffalo Bills defensive back Damar Hamlin may have suffered a “remarkably rare” condition when he collapsed on the field during Monday night’s game against the Cincinnati Bengals, CBS News medical contributor Dr. David Agus told “CBS Mornings.” The Bills said Hamlin suffered cardiac arrest following a hit in the game.
Video shows that after the hit, he stood up, took a few steps and fell to the ground.
While it’s not yet clear what caused Hamlin’s heart to suddenly stop beating,
Agus believes he sustained blunt force trauma to his chest “in the exact right spot,
at the exact right moment during his heartbeat,” which caused his heart to have an
arrhythmia — “not beat effectively to push blood to the brain.”
Agus suspects Hamlin’s heart was in ventricular fibrillation.
“What we know with commotio cordis, which is this condition, is that every minute you delay shocking them, resuscitating them, what happens is there’s an increase of 10% in mortality,” Agus said. “They started CPR right away, which is great. My hope is they were able to restore the heart rate soon enough to be able to get blood flow to the brain so there’s no damage there.”
Only about 30 of these cases happen in the United States each year, predominantly in children, according to Agus. “It happens in Little League baseball. A ball is thrown by a pitcher and hits the person in the chest,” Agus said. “It happens in soccer where there’s something that causes that blunt force trauma. So, remarkably rare.”
Hamlin’s heartbeat was restored on the field, according to the Buffalo Bills. On Tuesday, the team confirmed Hamlin spent the night in the intensive care unit and remained in critical condition at the University of Cincinnati Medical Center. “We are grateful and thankful for the outpouring of support we have received thus far,” the team tweeted.
The remainder of the game was postponed following the injury. The NFL said Tuesday that the game would not be resumed this week. In a statement Tuesday, Hamlin’s family thanked first responders and healthcare professionals at the University of Cincinnati Medical Center for their “exceptional care.” They also expressed their “gratitude for the love and support shown to Damar during this challenging time.”
“Your generosity and compassion mean the world to us,” the family said. “Please keep Damar in your prayers.” Agus anticipates more about Hamlin’s state will be known over the next day. “We are going to know a lot over the next 12 to 24 hours as they start to turn down the machine that’s breathing for him, the ventilator, to see if he can breathe on his own, and our hopes and prayers are that he can,” Agus said.
What is commotio cordis? – Search (bing.com)
The right hit at the wrong time may have triggered a rare phenomenon known as commotio cordis, heart experts suggest. It’s thought that commotio cordis occurs about
15 to 20 times a year in the U.S., mostly also in adolescents participating in sports like baseball, hockey or lacrosse, said Dr. Mark Link, a cardiologist at the University of Texas Southwestern Medical Center.
It’s even rarer for people over age 20, because ribs harden with age and are better
able to protect against blunt trauma, said Link, an expert in commotio cordis who
is a clinical cardiac electrophysiologist specializing in heart rhythm problems. NFL players undergo myriad health screenings, which may include scans of the heart, to identify potential health problems long before they hit the field.
“Every athlete has a comprehensive physical every year,” said Dr. James Voos, an orthopedic sports medicine specialist and head team physician for the Cleveland
Browns since 2014. Some, but not all, undergo cardiac screenings, such as EKGs and echocardiograms to look for problems with the heart’s structure or electrical system.
What’s more, Voos said, “every team has a cardiology consultant that partners with the team.” Such screenings suggest that an underlying cardiac condition would be unlikely to go unnoticed, Mokadam said. Still, there could be other reasons a person goes into cardiac arrest. Sometimes, a blood vessel within the heart muscle swells and bursts. Mokadam said that is unlikely to have happened in Hamlin’s case.
“If it was an aneurysm that burst, he would have needed emergency open heart surgery,” he said. “CPR and an AED aren’t going to take care of the problem.” (AED refers to a
form of defibrillation treatment.)
Dr. Korin Hudson a physician specializing in sports and emergency medicine at MedStar Health in Washington, D.C. said “there are a number of cardiac conditions that don’t always show up on those pre-participation exams.” Hudson recently worked with the Baltimore Ravens to streamline the team’s sideline emergency protocols.
Medical personnel were on hand and jumped to action when Hamlin collapsed Monday, potentially saving his life.
Medstar Health’s Hudson said that the National Football League mandates at least 27 medical personnel to be on site for each team on game days. The group includes athletic trainers, doctors who specialize in head trauma, and those who treat players with broken bones, damaged tendons or torn ligaments.
Though cardiac arrests on the football field are rare, Hudson said doctors are ready and able to do more than sit on the sidelines.
“Most medical professionals will see a catastrophic injury maybe once or twice in their career,” Hudson said. “That doesn’t mean we don’t need to be absolutely prepared to handle them at a moment’s notice.”
Jon Torine, who previously worked as a strength and conditioning coach for both
the Buffalo Bills and the Indianapolis Colts, said player safety was a top priority.
“There’s not a safer place to be than on an NFL team,” said Torine.
In a statement released Tuesday, Hamlin’s family thanked first responders and health care professionals at the University of Cincinnati Medical Center, where he is being treated.
“On behalf of our family, we want to express our sincere gratitude for the love and support shown to Damar during this challenging time,” the family wrote.
Dr. McCullough Assesses Damar Hamlin’s Cardiac Arrest and Rules out Commotio Cordis (rumble.com)
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Damar Hamlin is alert and asking questions, doctors say (nbcnews.com)
What’s next?
The 24 hours after such an injury are critical, doctors say. Physicians are most likely doing a number of tests to make sure there are no underlying heart problems that could have led to Hamlin’s collapse or injuries he sustained after Monday night’s collision. They could include an ultrasound of the heart, a cardiac MRI and CT scans of the brain.
Doctors caring for Hamlin are likely watching for signs that he can breathe on his own and is slowly able to respond to simple commands.
Special Dave Lapham In The Trenches Livestream | Damar Hamlin – Bills vs Bengals – Bing video
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At 8:55 pm A scary and emotional scene unfolded early during Monday
night’s game between the Bills and Bengals.
With 5:58 remaining in the first quarter, Bills safety #3 Damar Hamlin
collapsed seconds after tackling Bengals wide receiver #85 Tee Higgins.
He received immediate medical attention on the field and was transported
to the UC Medical Center in Cincinnati.
Hamlin, 24, suffered a cardiac arrest following the hit with his heartbeat restored
on the field, the Bills announced in a statement early Tuesday morning.
John 8:55 Though you do not know him, I know him. If I said I did not,
I would be a liar like you, but I do know him and obey his word.
Proverbs 5:5-8 My son, pay attention to my wisdom, turn your ear to my words of insight, 2 that you may maintain discretion and your lips may preserve knowledge.
Proverbs 8:5, KJV: O ye simple, understand wisdom: and ye fools, be ye of an understanding heart.
Elevated Cardiac Enzymes Could Signal a Heart Attack or Other Ailments
By Mikel Theobald Updated April 17, 2020 Medically Reviewed by Noelle LoConte, M.D.
A common reason for testing cardiac enzyme levels is to determine if someone is having a heart attack. However, that’s not the only reason levels rise. Pulmonary embolism, sepsis, drug toxicities, overexertion and other triggers can also raise levels. Elevated enzymes may signal something is wrong.
What are Cardiac Enzymes?
Cardiac enzymes are proteins or chemicals that are released into the bloodstream in response to some catalyst or process in the body. These substances serve as biomarkers, which help clinicians detect certain heart problems. Cardiac enzymes are measured with blood tests. The National Center for Biotechnology Information (NCBI) reports that also cardiac enzyme testing has been used since the mid-20th century to determine if someone is having or has had a heart attack.
Types of cardiac enzymes include creatine kinase (CK) and a subtype called CK-MB.
CK is found in the heart, skeletal muscle and brain, but CK-MB is found almost exclusively in the heart. For many years, tests measuring CK and CK-MB were used to diagnose heart attacks.
More recently, says NCBI, these tests have been largely replaced by measuring another protein called troponin. There are three subtypes of troponin: troponin C, troponin I and troponin T. Elevated troponin I and troponin T are most often indicative of heart muscle damage, whereas elevations in troponin C, CK and CK-MB can be associated with a host
of other conditions.
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Measure of a Heart Attack
Ben Shepple, MD, a cardiologist at the University of Tennessee Medical Center, explains that when cardiac enzyme levels are elevated, additional blood tests may be done to keep an eye on the numbers. “If cardiac enzymes are elevated, then they are typically followed over time to see if they increase, decrease or stay the same,” Dr. Shepple says. “Rapidly increasing cardiac enzymes are typically due to a heart attack.
“Cardiac enzyme tests are a lagging indicator and can take hours to show up in the blood after a heart attack has started,” he adds. “If a patient has cardiac enzymes tested soon after a heart attack starts, levels are often normal. For this reason, cardiac enzyme tests are typically repeated four to six hours later.” Depending on the symptoms, a doctor may recommend additional tests, says the American Heart Association.
These may include an echocardiogram, stress test or coronary angiography.
Other Reasons for Elevated Enzymes
Elevated cardiac enzymes can be an indication of health conditions or reasons other than heart attack. According to a research review published in the Journal of Cardiology
& Current Research (JCCR) in January 2018, this includes open heart surgery, strenuous exercise, chemotherapy, atrial fibrillation and blunt trauma to the chest. Other possibilities, per the JCCR review, include:
Brain disorders. People with elevated troponin have increased risk factors for stroke. Additionally, after a stroke, troponin levels help determine prognosis for short-term and long-term outlook.
Respiratory conditions: Certain lung disorders have been linked to elevated cardiac enzymes. The most common is a pulmonary embolism, which is a blood clot in the lungs. About 30 to 50 percent of people with pulmonary embolism have elevated troponins, according to the JCCR review.
Kidney disease: People with kidney disease are at increased risk for heart disease and heart attacks. Nevertheless, cardiac enzymes are often elevated in people with kidney disease who are not experiencing a heart attack. Decreased kidney function likely contributes to chronically elevated cardiac enzymes, as the kidneys are responsible for clearing cardiac enzymes from the body.
Severe infection: A severe bloodstream infection called sepsis is associated with elevated cardiac enzymes. The body responds to sepsis with an inflammatory response that can affect multiple organs, including the heart.
Skeletal muscle injury: Trauma to the muscle, alcohol and drug use, serious illness, certain prescribed medications and overexertion during exercise can lead to a skeletal muscle injury called rhabdomyolysis. As cells are damaged, cardiac enzymes are released, boosting levels of CK and troponins. People with rhabdomyolysis who have elevated levels of troponins are sicker for longer than individuals who have this condition but do not have elevated levels of this biomarker.
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