-Case Reports-

A Case of Commotio Cordis Caused by Steering Wheel Injury

Noriyoshi Kutsukata, Kunihiro Mashiko, Hisashi Matsumoto, Yoshiaki Hara, Yuichiro Sakamoto and Hiroyuki Koami

Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School
Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital

We report a rare case of commotio cordis caused by traffic injury. The patient was a 60-year-old female driver who suffered severe steering wheel impact to the chest during a head-on collision in which her car overturned. She had no history of cardiac disease. Emergency medical services arrived at the scene within 12 minutes of the accident. Evidence of ventricular fibrillation led the paramedics to carry out immediate defibrillation with an automated external defibrillator. Restoration of spontaneous circulation was confirmed within 2 minutes, along with establishment of sinus rhythm and normal wave form on electrocardiography. The patient was transported to our hospital in an emergency helicopter. General examination revealed chest bruising, and computed tomography of the chest showed pulmonary contusions; there was no other evidence of critical injury. We performed endotracheal intubation, as the patient had consciousness disturbance, and then initiated hypothermic therapy in the intensive care unit. Meanwhile, the hemodynamics remained stable, and there was no recurrence of arrhythmia. On day 15, the patient's consciousness improved, and she was able to communicate. Two months later, she was transported to another hospital for rehabilitation.

J Nippon Med Sch 2010; 77: 218-220

Keywords
commotio cordis, traffic accident, traffic injury, steering wheel injury

Correspondence to
Noriyoshi Kutsukata, Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
moonsong@nms.ac.jp

Received, March 26, 2010
Accepted, April 20, 2010