re: Report: Hamlin did not have pre-existing cardiac issues; collision was cause of incident

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not hard in the sense that It would've appeared on ESPN'S old "jacked up" segment. But it was definitely hard in the sense that if you were on the receiving end of it

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Like Dale Earnhardts wreck. It was dull as dirt. No flames no spin no flips. Just a solid hard impact.

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I read an article written by a cardiologist saying the fact that he had to be resuscitated twice,once on the field and once later in his opinion does a way with the fact that the impact could’ve caused this

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This "fact" is not at all true.

He lost his pulses/received CPR/was defibrillated ONLY on the field. There was no second cardiac arrest. This was rapidly clarified by the family and later by the physicians caring for him, after an uncle inaccurately reported that it had happened again at the hospital.

Fake news

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For the 50th time, Damars treating neurologist, Dr. William Knight said that commitio cordis is least likely the cause of him coding

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That’s not what he said in the quote you provided.

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Thats exactly what he said

!) extremely rare- Yes
2) a diagnosis of exclusion - Yes
3) have to rule out via testing, everything else first - Yes

Thats exactly what "least likely" means. - NOPE
Every other condition gets ruled out before we even consider it to be at commitio cordis Yes

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a diagnosis of exclusion does not mean something has to be the least likely diagnosis. It just means there is no good test for it and the things that could be intervened upon/are dangerous need to be ruled out before settling on the diagnosis.

To give an every day example - first trimester vaginal bleeding occurs in approximately 25% of pregnancies and is most commonly benign (implantation bleeding or threatened spontaneous abortion). However these are diagnoses of exclusion, so the standard of care is to rule out less common, more dangerous causes such as ectopic pregnancy, heterotopic pregnancy, molar pregnancy, incomplete spontaneous abortion, cervical malignancy, etc. Once these are ruled out, the diagnosis of exclusion -threatened spontaneous abortion (which is also the most likely diagnosis when they walk in the door) is given.

In this case, I am confident they
- rapidly ruled out acute coronary syndrome (most common cause of cardiac arrest) and pericarditis via EKG and likely serial troponins.

- ruled out HOCM via echo.

- ruled out preexisting conditions long QT, brugada, WPW, and ARVD with EKGs

-ruled out severe metabolic derangements such as hyper/hypokalemia and hypomagnesemia (would be unlikely in a young healthy patient) with labs

- profound hypo/hyperthermia was ruled out by taking his temperature (even though it was very unlikely)

- As I had pointed out before acute R sided heart failure secondary to PE does not at all fit his presentation but was also ruled out with an echo and ct chest that they were doing anyway.

- based on presentation (and subsequent workup), traumatic aortic dissection, pericardial effusion leading to tamponade, hemorrhagic shock, and tension hemo/pneumothorax were ruled out

- ruled out intracranial pathology (traumatic intracranial hemorrhage, ruptured aneurysm, or malignancy via head CT (and likely follow up MRI)

-ruled out lightening strike or shock by a high voltage line via video review

- likely performed a urine drug screen to rule out accidental opioid overdose (very common in general population but highly unlikely in this case)

And so we are left with Commotio Cordis as the most likely diagnosis, now that other things that could be tested for have been ruled out.

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Almost every single instance of commotio cordis happens in teen boys that get hit with a baseball in the chest. A 90 MPH baseball hitting the chest of a not fully developed kid's unprotected chest VS a 15 MPH helmet hitting a pad protected chest. These are worlds apart.

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How about this?

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And another reason Dr Knight is looking at everything else first

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That’s how you diagnose by exclusion.

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bullshite.

Barely any collision.


They just expect everyone to eat up this horseshite narrative and not ask questions huh?

Confirms to me it was the vaccine.

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Covid has broken some of you.

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Well, in this case it does

By extremely rare, he means
* its never been reported outside the teen years.

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What? It has happened outside of teen years, what are you talking about?