Damar Hamlin

Overview of Differential Diagnosis for Sudden Cardiac Arrest

Dear Super Beens,

As much as the whole country is talking about this young man, it is incorrect for us to make conclusions. And, we do not have enough data. Hence sharing a few public articles and my comment on such cases but not specifically for Damar. May he recover completely and soon.

The differential diagnosis d/d is the set of possibilities behind a clinical outcome. In case of sudden collapse with cardiac arrest some d/ds are the following:

1. A rare commotio cordis (CC) during the game by an impact, especially when the heart rate is high, (increases the chances of CC to occur.) Less than 30 cases yearly in the US occur.

An excerpt from this article is interesting:

"Children appear to be at the highest risk for commotio cordis. The mean age reported in the registry is 15 years, and very few cases have been reported above 20 years old."

Reference: https://www.ncbi.nlm.nih.gov/books/NBK526014/

2. Underlying ischemic or inflamed condition increasing vulnerability. In this point any vaccine related inflammation will be a possibility. Less data available to rule in or out vaccine caused inflammation.

3. Hypertrophic obstructive cardiomyopathy. Can cause sudden death. More common than CC. An article has assessed the incidence to be 100,000/year in the US.

"In conclusion, leveraging a claims-based data analytic technique, about 100,000 patients are diagnosed clinically with HC in the US, an occurrence which is less than the prevalence reported in systematic population studies based on echocardiographic diagnosis."

Reference: https://pubmed.ncbi.nlm.nih.gov/27006153/

4. Congenital reasons for arrythmias.

I deliberately left out my opinion of Damar's case. I will add it to comments if you like.

A good article from AHA: https://www.ahajournals.org/doi/10.1161/JAHA.118.011700

Latest from CNN: https://www.cnn.com/us/live-news/damar-hamlin-nfl-buffalo-bills-news-01-04-23/index.html

Latest from Fox: https://www.foxnews.com/sports/bills-damar-hamlin-shown-signs-improvement-still-critical-condition-team-says

Finally a general list of differential diagnosis for sudden cardiac arrest in youngsters:

1. Coronary artery disease: A blockage or narrowing of the coronary arteries that supply blood to the heart can lead to sudden cardiac arrest.

2. Cardiomyopathy: This is a condition in which the heart muscle becomes weakened or enlarged, leading to an increased risk of sudden cardiac arrest.

3. Hypertrophic cardiomyopathy: This is a condition in which the heart muscle becomes thickened, leading to an increased risk of sudden cardiac arrest.

4. Valvular heart disease: Abnormalities or damage to the heart valves can lead to sudden cardiac arrest.

5. Pulmonary embolism: A blood clot that travels to the lungs and blocks a blood vessel can lead to sudden cardiac arrest.

6. Aortic aneurysm: A weak or bulging area in the aorta, the main blood vessel leading from the heart, can lead to sudden cardiac arrest.

7. Long QT syndrome: This is a rare genetic disorder that can cause abnormal heart rhythms and increase the risk of sudden cardiac arrest.

8. Substance abuse: Abusing drugs such as cocaine or amphetamines can increase the risk of sudden cardiac arrest.