Commotio Cordis Confirmed as Cause of Damar Hamlin’s Cardiac Arrest

Damar Hamlin, the Buffalo Bills safety who suffered a cardiac arrest during a National Football League (NFL) game watched by millions live earlier this year, has confirmed that the cause of his collapse was commotio cordis.

Hamlin announced the news—something long suspected by the cardiology community—during a Bills press conference today.

“Over these last few months, I’ve been on a journey, and I’ve seen some of the top professionals across the country and their answers to me were . . . all the same,” Hamlin said. “What happened to me was basically commotio cordis: it’s a direct blow at a specific point in your heartbeat that causes cardiac arrest and 5 to 7 seconds later, you fall out.”

That, he said, is what viewers witnessed during Monday Night Football on January 2, 2023.

In response to the news, the American Heart Association (AHA) issued a press release reminding physicians and the general public that there are no known risk factors for commotio cordis, but that swift action can save a life.

“If there’s one lesson that we can all learn, it’s that the best way to help anyone survive a cardiac emergency including commotio cordis is for as many of us as possible to learn CPR,” Gordon Tomaselli, MD (Albert Einstein College of Medicine in the Bronx, New York, NY), AHA past president, is quoted in the release. “And for each of us to be ready and able to respond to a cardiac emergency that can occur literally anywhere. Immediately beginning the steps in the chain of survival—calling 911, prompt CPR and defibrillation—these are essential to saving someone’s life, and they must begin within the seconds and minutes after the individual collapses.”

If CPR and defibrillation are initiated promptly, he added, “the survival rate is now quite good, in excess of 50%, which is a vast improvement to the less than 10% survival rate for most out-of-hospital cardiac arrests. And, in most cases, the individual affected is able to resume their previous life and activities.”

Hamlin, during the press conference, went on to say: “This event was life-changing but it’s not the end of my story, so I’m here to announce that I plan on making a comeback to the NFL. . . . My heart is still in the game.”

He also indicated that he hopes to play an advocacy role to raise awareness about this rare event. “Commotio cordis is the leading cause of death in youth athletes across all sports, so that’s something that I personally will be taking a step into, to make a change,” said Hamlin. Notably, he continued, awareness around CPR and access to automated external defibrillators have been lower among young athletes, something he hopes can change.

Hamlin has already announced a collaboration with the AHA to launch the #3forHeart CPR Challenge to educate people about the importance of learning CPR.

Byron K. Lee, MD (University of California, San Francisco), who back in January blogged for TCTMD about commotio cordis as the most plausible explanation for Hamlin’s arrest, said: “It’s great news that Damar has made a full recovery and that his doctors found no unexpected cardiac disease. Thanks to this incident, people worldwide now know about commotio cordis and what to do when they see it.”

As for Hamlin’s return to play, Lee told TCTMD in an email that “although chest protection has not been proven to prevent commotio cordis, I think Damar would be wise to use it when he returns to football.”