What is commotio cordis? Damar Hamlin survived the same condition that claimed the life of Spanish soccer player Jesus de Miguel

The sudden death of Spanish soccer player Jesus de Miguel has drawn attention to commotio cordis, a rare and potentially fatal cardiac event that can cause the heart to stop following an impact to the chest – one that the Buffalo Bills ’ Damar Hamlin managed to survive.

The 30-year-old De Miguel suffered serious head and chest injuries during Tenerife 's second-division soccer match against FC Andorra in a collision that occurred seven minutes into stoppage time, when J esus Owono came out to clear a long ball.

The goalkeeper struck the forward with his knee, and he crumbled to the ground before receiving treatment on the pitch before being taken to hospital by ambulance as his condition was initially described as stable but serious, before deteriorating the following morning.

Tenerife confirmed that he died at 08:00 local time in Spain on Tuesday and a Spanish emergency-services specialist subsequently raised the possibility that De Miguel had experienced commotio cordis as Javier G. Rendo suggested the impact could have triggered an electrical disturbance in the heart.

Hamlin endured the same condition and collapsed during an NFL game in January 2023 pulled through, although Rendo stressed that this remained a hypothesis rather than a confirmed medical diagnosis.

How does commotio cordis happen?

The term commotio cordis comes from Latin and translates as agitation of the heart, describing a rare cardiac arrest caused by a blunt impact to the chest, which can disrupt the heart's electrical rhythm and trigger ventricular fibrillation.

The timing of the blow is crucial. The impact must occur during an extremely narrow window in the heartbeat, estimated at approximately 20 to 40 milliseconds, when the heart is particularly vulnerable to an electrical disturbance.

The location and force of the impact also matter as a blow must strike directly over the heart, while being neither too strong nor too weak and the resulting ventricular fibrillation prevents the heart from pumping blood effectively and can cause a person to collapse within seconds.

Commotio cordis is not limited to professional athletes or high-impact sports, and cases have been associated with relatively ordinary incidents, including being struck by a ball, falling from a bicycle or receiving an accidental blow during play.

How did Damar Hamlin survive commotio cordis?

Hamlin suffered his cardiac arrest during the Bills ' game against the Cincinnati Bengals as the safety collapsed after making a tackle, with the impact to his chest triggering commotio cordis and his survival highlighted the importance of an immediate emergency response.

CPR and rapid access to an automated external defibrillator can be critical, because the condition requires urgent treatment to restore a normal heart rhythm. It is believed that without witnesses recognizing the emergency, starting CPR, contacting emergency services and using a defibrillator, survival is unlikely.

Hamlin later confirmed his diagnosis and was cleared to return to football after assessments by multiple specialists and continues to play in the NFL to this date, now aged 28. He has made 10 tackles through seven games of the 2026 campaign.

The 2025 European Resuscitation Council guidelines also recognize commotio cordis as an uncommon cause of cardiac arrest in athletes, emphasizing the need for rapid recognition and defibrillation when required.

In De Miguel 's case, however, there is no public medical confirmation that commotio cordis caused his death, and establishing the precise medical explanation will require clinical findings.