THE MOTHER OF a teenager who collapsed while playing hurling helped saved her son’s life after a blow from a sliotar caused his heart to stop beating. 

The boy (13), whose case is detailed in this month’s Irish Medical Journal (IMJ), collapsed after the hurling ball hit him in the chest. 

The boy’s mother, a nurse, commenced CPR almost immediately after finding he had no pulse. A defibrillator was then applied to his chest and his heart beat was revived immediately. 

Although reported in other sports, this is the first confirmed case of commotio cordis (CC) – disruption of the heart’s rhythm – caused by a sliotar, a solid round ball used in hurling.

Following the incident, the boy, whose heart stopped beating for less than four minutes, made a full recovery, according to medics at Galway University Hospital and Our Lady’s Children’s Hospital, Crumlim, who studied the incident. 

CC is a rare but important cause of sudden cardiac death, the report notes. It occurs as a result of a blow to the area of the chest directly over the heart at a critical time during the cycle of a heartbeat.

Considering most cases of CC occur in adolescents and have a high mortality rate, the report notes, “timely management of cardiac arrest is key”. 

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The case report notes that the use of protective chest shields or soft balls are the most common suggestions for preventing CC in sports like hurling. 

However, even when worn, chest shields are not entirely protective against CC, “particularly in such an agile sport where the shield would move,” the report notes. 

In addition, replacing the sliotar with a soft ball is unlikely to be accepted as the fundamental characteristics of the game would be “significantly altered”. 

The medical report suggests, therefore, that efforts instead should focus on the response to cardiac arrest.

“Due consideration has been given to introducing a public access [defibrillator] programme,” the report notes. 

“However, the cost benefit analysis of implementing an effective scheme and the large number of [defibrillators] already provided on a voluntary basis suggest public expenditure be otherwise appropriated.”

There is currently no mandated requirement to upkeep voluntary defibrillators or the defibrillator registry in Ireland, however, the report notes. 

“We believe that prompt access to existing, well maintained [defibrillators], effective CPR and integration with emergency services will improve survival in out of hospital cardiac arrests whether from rare causes like CC or more common causes.”

Although a CC registry exists in the US, the IMJ report notes, it does not exist in Europe where it is likely to be under-reported.