"Headbutt" and Commotio Cordis

During the 2006 FIFA World Cup final match, Zidane was sent off for violent behavior after "headbutting" one of Italy players in the chest in the 110th minute. Luckily, the attacked player, Marco Materazzi, rapidly recovered and even went on to score Italy's second penalty in the shoot-out, which Italy won 5-3, to win the World Cup.



The consequences could have been much different though if Materazzi had gone into cardiac arrest due to commotio cordis.

Ventricular fibrillation and sudden death triggered by a blunt, nonpenetrating, and often innocent-appearing unintentional blow to the chest without damage to the ribs, sternum, or heart (and in the absence of underlying cardiovascular disease) constitute an event known as commotio cordis, which translates from the Latin as agitation of the heart. This term was first used in the 19th century. However, the occurrence of commotio cordis was described earlier, in accounts of the ancient Chinese martial art of Dim Mak (or touch of death), in which blows to the left of the sternum caused sudden death in opponents.

Commotio cordis is a recognized cause of sudden death in young athletes in which a blow to the chest causes ventricular fibrillation and cardiac arrest.

In 70% of cases, the victim was struck by a projectile, which was most commonly a baseball or a hockey puck. In 30%, chest trauma resulted from bodily contact with another person or an object.

Survival after commotio cordis is unusual.

References:

Zinedine Zidane, from Wikipedia, the free encyclopedia.
Commotio cordis--a report of three cases. Int J Legal Med. 2005.

Commotio Cordis. NEJM, 2010.
Commotio Cordis. eMedicine.
Commotio cordis from Wikipedia, the free encyclopedia.
Zidane. The French Hero who was, ultimately, just a Man. WSJ.
Zidane the Web Game, via Google Blogoscoped.
Top Soccer Players Are Seen to Have Superior Brain Function - NYTimes, 2012 -- Good to know, NYT.

Related reading:

Lethal headbutt. AP, 09/2007.
Is the Superbowl Hazardous to Your Health?Once again, the New England Journal of Medicine has sunk to new lows in the interest of increasing its impact factor. Dr. Wes, 01/2008.
Commotio Cordis. Life in the fast lane, 2010.