{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:09:06Z","timestamp":1771632546182,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Myocarditis is a known cause of sudden cardiac death of the athlete. The impact of direct chest trauma in at-risk sports or activities in patients with a history of myocarditis has never been demonstrated or studied. We report herein two cases of life-threatening ventricular arrhythmia secondary to non-penetrating blunt chest trauma while playing contact sports.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>The first patient, a 26-year-old man described a brief loss of consciousness after having received blunt impact to the chest (typical intensity) while playing a rugby match. The loss of consciousness was total and proceeded by rapid and regular palpitations. He had a history of viral myocarditis 10\u2009years prior with a fibrotic sequalae in the inferolateral wall on cardiac magnetic resonance imaging (left ventricular ejection fraction 71%). Right apical ventricular pacing induced a sustained monomorphic ventricular tachycardia reproducing the patient\u2019s symptoms. A subcutaneous implantable cardioverter-defibrillator was implanted. The second patient is a 22-year-old professional rugby player with no known notable history. During a match, a direct blow to the chest wall was followed by a cardiac arrest. A ventricular fibrillation was cardioverted to pulseless electrical activity. Patient died despite cardiopulmonary resuscitation. An autopsy identified a myocardial sequela of fibrosis with no acute inflammatory remodelling compatible with a previous myocarditis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Myocarditis may increase the risk of life-threatening ventricular arrhythmias caused by blunt impact to the chest, particularly in contact sports. Screening and prevention measures should be considered to reduce this risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab054","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T22:37:58Z","timestamp":1614983878000},"source":"Crossref","is-referenced-by-count":6,"title":["Sudden cardiac death risk in contact sports increased by myocarditis: a case series"],"prefix":"10.1093","volume":"5","author":[{"given":"Gr\u00e9goire","family":"Massoulli\u00e9","sequence":"first","affiliation":[{"name":"Cardiology Department, CHU Clermont-Ferrand , Rue Montalembert, 63000 Clermont-Ferrand, France"},{"name":"Universit\u00e9 Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont , Institut Pascal, F-63000 Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baptiste","family":"Boyer","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, CHU Clermont-Ferrand , Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7452-315X","authenticated-orcid":false,"given":"Vincent","family":"Sapin","sequence":"additional","affiliation":[{"name":"Biochemistry Department, CHU Clermont-Ferrand , Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4790-3533","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Jean","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Clermont-Ferrand , Rue Montalembert, 63000 Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Andronache","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Clermont-Ferrand , Rue Montalembert, 63000 Clermont-Ferrand, France"},{"name":"Universit\u00e9 Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont , Institut Pascal, F-63000 Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Peoc\u2019h","sequence":"additional","affiliation":[{"name":"Department of Pathology, CHU St-Etienne , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-5178","authenticated-orcid":false,"given":"Guillaume","family":"Clerfond","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Clermont-Ferrand , Rue Montalembert, 63000 Clermont-Ferrand, France"},{"name":"Universit\u00e9 Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont , Institut Pascal, F-63000 Clermont-Ferrand, France"},{"name":"INI-CRCT F-CRIN , Nancy, France For the podcast associated with this article, please visit https:\/\/academic.oup.com\/ehjcr\/pages\/podcast"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Eschalier","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Clermont-Ferrand , Rue Montalembert, 63000 Clermont-Ferrand, France"},{"name":"Universit\u00e9 Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont , Institut Pascal, F-63000 Clermont-Ferrand, France"},{"name":"INI-CRCT F-CRIN , Nancy, France For the podcast associated with this article, please visit https:\/\/academic.oup.com\/ehjcr\/pages\/podcast"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"key":"2022081117450273300_ytab054-B1","first-page":"e273","article-title":"Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis","volume":"132","author":"Maron","year":"2015","journal-title":"Circ Am Heart Assoc"},{"key":"2022081117450273300_ytab054-B2","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/S0735-1097(86)80283-2","article-title":"Causes of sudden death in competitive athletes","volume":"7","author":"Maron","year":"1986","journal-title":"J Am Coll Cardiol"},{"key":"2022081117450273300_ytab054-B3","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.hrthm.2012.11.024","article-title":"Incidence of cardiovascular sudden deaths in Minnesota high school athletes","volume":"10","author":"Maron","year":"2013","journal-title":"Heart Rhythm"},{"key":"2022081117450273300_ytab054-B4","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.amjmed.2016.02.031","article-title":"Demographics and epidemiology of sudden deaths in young competitive athletes: from the United States National Registry","volume":"129","author":"Maron","year":"2016","journal-title":"Am J Med"},{"key":"2022081117450273300_ytab054-B5","first-page":"2047487320909670","article-title":"Myocarditis in athletes: a clinical perspective","author":"Halle","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022081117450273300_ytab054-B6","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1161\/01.CIR.0000118493.13323.81","article-title":"Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology","volume":"109","author":"Mahrholdt","year":"2004","journal-title":"Circulation"},{"key":"2022081117450273300_ytab054-B7","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/j.jacc.2020.01.036","article-title":"Ventricular arrhythmias in myocarditis: characterization and relationships with myocardial inflammation","volume":"75","author":"Peretto","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2022081117450273300_ytab054-B8","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1093\/eurheartj\/ehi325","article-title":"Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology","volume":"26","author":"Pelliccia","year":"2005","journal-title":"Eur Heart J"},{"key":"2022081117450273300_ytab054-B9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/eurheartj\/ehy730","article-title":"Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC)","volume":"40","author":"Pelliccia","year":"2019","journal-title":"Eur Heart J"},{"key":"2022081117450273300_ytab054-B10","doi-asserted-by":"crossref","first-page":"2793","DOI":"10.1093\/eurheartj\/ehv316","article-title":"2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)","volume":"36","author":"Priori","year":"2015","journal-title":"Eur Heart J"},{"key":"2022081117450273300_ytab054-B11","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/j.1540-8167.1999.tb00648.x","article-title":"Clinical profile of commotio cordis: an under appreciated cause of sudden death in the young during sports and other activities","volume":"10","author":"Maron","year":"1999","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2022081117450273300_ytab054-B12","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1161\/01.CIR.100.4.413","article-title":"Selective activation of the K(+)(ATP) channel is a mechanism by which sudden death is produced by low-energy chest-wall impact (Commotio cordis)","volume":"100","author":"Link","year":"1999","journal-title":"Circulation"},{"key":"2022081117450273300_ytab054-B13","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1056\/NEJM199508103330602","article-title":"Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities","volume":"333","author":"Maron","year":"1995","journal-title":"N Engl J Med"},{"key":"2022081117450273300_ytab054-B14","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.amjcard.2019.05.050","article-title":"A lethal blow to the chest as an underdiagnosed cause of sudden death in United Kingdom Sports (Football, Cricket, Rugby)","volume":"124","author":"Cooper","year":"2019","journal-title":"Am J Cardiol"},{"key":"2022081117450273300_ytab054-B15","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1016\/j.hrthm.2011.07.014","article-title":"Global epidemiology and demographics of commotio cordis","volume":"8","author":"Maron","year":"2011","journal-title":"Heart Rhythm"},{"key":"2022081117450273300_ytab054-B16","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1177\/1741826710389363","article-title":"Commotio cordis\u2014under-recognized in Europe?: a case report and review","volume":"18","author":"Solberg","year":"2011","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"2022081117450273300_ytab054-B17","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1001\/jama.287.9.1142","article-title":"Clinical profile and spectrum of commotio cordis","volume":"287","author":"Maron","year":"2002","journal-title":"JAMA"},{"key":"2022081117450273300_ytab054-B18","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.legalmed.2019.04.007","article-title":"The role of the autopsy in the diagnosis of commotio cordis lethal cases: review of the literature","volume":"38","author":"Lupariello","year":"2019","journal-title":"Leg Med"},{"key":"2022081117450273300_ytab054-B19","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1161\/CIRCULATIONAHA.115.015431","article-title":"Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes: a decade in review","volume":"132","author":"Harmon","year":"2015","journal-title":"Circulation"},{"key":"2022081117450273300_ytab054-B20","doi-asserted-by":"crossref","first-page":"e007848","DOI":"10.1161\/CIRCIMAGING.118.007848","article-title":"Commotio Cordis in a professional soccer player: value of MRI in unraveling myocardial damage","volume":"11","author":"Zeldetz","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2022081117450273300_ytab054-B21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jsams.2013.01.007","article-title":"Quantification of tackling demands in professional Australian football using integrated wearable athlete tracking technology","volume":"16","author":"Gastin","year":"2013","journal-title":"J Sci Med Sport"},{"key":"2022081117450273300_ytab054-B22","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s40279-017-0838-4","article-title":"The incidence of injury in amateur male rugby union: a systematic review and meta-analysis","volume":"48","author":"Yeomans","year":"2018","journal-title":"Sports Med"},{"key":"2022081117450273300_ytab054-B23","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1161\/CIRCULATIONAHA.120.049252","article-title":"COVID-19: Myocardial injury in survivors","volume":"142","author":"Knight","year":"2020","journal-title":"Circulation"},{"key":"2022081117450273300_ytab054-B24","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"2022081117450273300_ytab054-B25","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1093\/eurheartj\/ehaa288","article-title":"COVID-19-related myocarditis in a 21-year-old female patient","volume":"41","author":"Kim","year":"2020","journal-title":"Eur Heart J"},{"key":"2022081117450273300_ytab054-B26","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/jamacardio.2020.1286","article-title":"Potential effects of coronaviruses on the cardiovascular system: a review","volume":"5","author":"Madjid","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2022081117450273300_ytab054-B27","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1249\/MSS.0000000000002411","article-title":"Left ventricular fibrosis in middle-age athletes and physically active adults","volume":"52","author":"Banks","year":"2020","journal-title":"Med Sci Sports Exerc"},{"key":"2022081117450273300_ytab054-B28","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1136\/bjsports-2014-094546","article-title":"Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie?","volume":"50","author":"Schnell","year":"2016","journal-title":"Br J Sports Med"},{"key":"2022081117450273300_ytab054-B29","author":"World Rugby Laws\u2014World Rugby\u2019s Law Education Web Site","year":"2020"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/3\/ytab054\/45348135\/ytab054.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/3\/ytab054\/45348135\/ytab054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T17:45:59Z","timestamp":1660239959000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab054\/6154461"}},"subtitle":[],"editor":[{"given":"Sabiha","family":"Gati","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"David","family":"Niederseer","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Danny","family":"van de Sande","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Max","family":"Sayers","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Vassilios Parisis","family":"Memtsas","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,28]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,2,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab054","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,2,28]]},"article-number":"ytab054"}}