Dr. IV Mirus on cardiac arrest

Alex: Hello!

Dr. IV Mirus: Hello.

Alex: We’re here to talk about the incident on Monday Night Football in which player Damar Hamlin’s heart stopped.

[Full-screen images showing Damar Hamlin and an ambulance on the field]

Alex: His health seems to be improving. As an emergency room doctor, can you explain what the cause could be? Have you seen other cases in which people’s hearts stop? What do you call this?

Dr. Mirus: Yes, it was a very frightening incident. It was so visible, on Monday Night Football, with so many people watching. It was very shocking and very unfortunate. There are many possible reasons why the heart stopped. I’m not 100% sure about that scenario. Obviously, his medical team would know more. I’ve seen some potential causes and one possibility — this has been documented in previous cases — is something that is called “Commotio Cordis.” What this means — this is very rare — but it happens. Sometimes in baseball, if there is blunt trauma on the chest, if it is in a specific place near the heart, the impact can cause the heart to stop. The exact reason why is difficult to explain. The heart is like a pump. It is the motor of the body. The top part moves like this. The bottom of the heart is like a large pump. There is a rhythm with both parts of the heart. If the heart is impacted when the bottom part is pumping, it can cause the electrical system in the heart to be disrupted. There is a pause, which is called fibrillation. The heart is out of sync. It is not pumping blood. It’s just moving very little. That would cause someone to pass out. Your brain must have oxygen and sugar at all times. It has an immediate, constant need and if there is no supply, the brain will start shutting down. That’s why you pass out and the brain starts to deteriorate immediately. That’s why the amount of time is so important. When the heart is in fibrillation, how do you get it back to normal? Electricity. That’s what happened on Monday Night Football. There were pads applied and when a machine was turned on, it shocked the heart to get it pumping again. But when the heart is in fibrillation, if you are not sure what is going on, that’s where CPR comes in. It is to push the heart to pump it and have blood flow to help perfuse the brain, with the hope that the brain will be okay. So it seems like that’s what happened.

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Alex: How important is it to immediately start CPR? What if we are in a similar situation? We may be at a school, at a mall, or at home with our family when someone has trauma to their chest that causes them to collapse. Basically, we shouldn’t wait before starting CPR? What do you suggest we do in that situation?

Dr. Mirus: Yes. The emergency medical staff who took care of Hamlin, in their announcement, said the reason why Hamlin was doing well is because of the immediate CPR he got on the field. The staffers noticed right away that he didn’t have a typical football injury. Something was wrong. So they felt his pulse and saw that he didn’t have a heartbeat. They started CPR to help push the blood to the brain. That is the biggest, most important thing that you can do. There are many different ways to become CPR certified. You can take classes. The American Heart Association is pretty good at providing interpreters. So I think it is a great opportunity to get a group of deaf people to go and take a class.

The other thing is to have a machine called an AED. That machine is available in many buildings such as schools, gyms, libraries…

Alex: I’ve seen these machines.

Dr. Mirus: Yes, the AED box that’s yellow. Many buildings have it. It has pads that you can put on someone’s chest. The machine can analyze what the heart is doing. If there is a normal heart rhythm, then the machine will say that there is no need to shock. It’s not a problem with the heart, it’s something else. But if the heart is in fibrillation, the machine will notice it and go ahead and shock the chest to restore the heart’s function. The machine can detect it and save lives. That’s what happened on Monday Night Football. So learning how to use an AED could save someone else’s life. But I know that some older AED machines are not deaf friendly because it is auditory based. So that may be a problem. Hopefully with future students, and deaf health researchers, someone can find a solution to that problem.

Alex: Thank you so much. Take care.

Dr. Mirus: Of course. Take care.