LI Cardiologist Assesses From Afar Rare Football Player's Collapsing

OCEANSIDE, NY — While the improvements are gradual, Buffalo Bills safety Demar Hamlin is still in critical condition after suffering cardiac arrest on the field Monday night.

What followed over the next 30 minutes was stunning for the national television audience as CPR was administered reportedly for nine minutes before an ambulance would drive him to a hospital.

Emotions ran so high that the game, after only minutes had elapsed, was indefinitely postponed.

Dr. Lawrence Kanner is the chief of cardiology and director of Electrophysiology/Arrhythmia Services at Mount Sinai South Nassau.

While not involved in the care of Hamlin, Kanner thinks he suffered the rare commotio cordis, where a blunt trauma to the heart causes a sudden arrhythmic death. Hamlin was resuscitated on the field.

"It's unlikely that he has a big scar from an old heart attack," Kanner told Patch. "Chances are he's going to have a normal structural evaluation."

Dr. Kanner said, assuming the structure of the heart checks out, the heart attack was either genetic or directly related to the hit.

He said commotio cordis became more understood after published medical reports in the mid-1990s. It's more common in baseball, especially little league, and hockey.

"Anything where there are projectiles," Kanner said.

It's also seen more often in people between ages 7-20, "and it's probably because the chest wall hasn't had enough time to mature" in adults.

There are two parts to the potentially lethal combination of commotio cordis: the object striking the chest and precise timing.

"Every heartbeat has a cardiac cycle. There is a vulnerable period during the cardiac cycle at which blunt trauma, even mild or moderate blunt trauma, can cause this kind of thing," he said. "We're talking maybe 10 or 15 milliseconds in the cardiac cycle where the chest is vulnerable."

While Kanner is hopeful that there is a good neurologic recovery, he also ponders a long-term scenario.

"Is he going to be allowed to play again? Although this is a random event and could probably happen to anyone, we really haven't worked out that there may be some people that are susceptible to this," he said.

One important takeaway from the tragic event in Cincinnati: the medical staff was quickly on the field assessing the situation, giving CPR and giving him AED (automated external defibrillator) to save his life. The doctor points to this as a reminder for having AED equipment and people properly trained.

"It's probably 4-5 hours of your time to call the American Heart Association to get trained on hands-on CPR," he said.