The T-Wave and Death by striking the solar plexus

 

 

 

I remember a discussion long ago with Dr. Paul Harper about whether strikes to the solar plexus could prove to be deadly. 

 

Dr. Harper besides being a Dan student of mine, was also an accomplished surgeon. We often had talks about the medical implications about karate practices.  

He also made it clear that only an idiot would ever listen to me on medical matters, and I most heartedly agree with that.

 

First looking on Bing I find the following:

 

Only chest impacts occurring on a narrow band of the ECG during the upslope of the T wave (40 milliseconds (ms) before the peak of the T wave to the instant of the actual peak) will cause the ventricular fibrillation of commotio cordis, with an increased probability occurring when an impact happens from 30 to 10 ms before the peak of the T wave.

Definition of Terms:

The T Wave

Both ventricles repolarise before the cycle repeats itself and therefore a 3rd wave (t wave) is visible representing ventricular repolarisation.

Image: The T Wave

 

Commotio cordis (Latin, "agitation or disruption of the heart") is a rare lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (the precordial region) at a critical time during the cycle of a heartbeat.^[1] This leads to disrupting normal heart electrical activity, followed instantly by ventricular fibrillation, complete disorganization of the heart's pumping function, and cardiac arrest. It is not caused by mechanical damage to the heart muscle or surrounding organs and is not the result of heart disease.

Its incidence in the United States is fewer than 20 cases per year, often occurring in boys participating in sports, most commonly in baseball when the hard ball strikes an unprotected chest.

Commotio cordis occurs upon impact within a narrow window of about 40 milliseconds in the cardiac electrical cycle, explaining why it is so rare.^[1]

If cardiopulmonary resuscitation (CPR) combined with use of an on-site automated external defibrillator is employed urgently, within three minutes of the impact, survival from commotio cordis can be as high as 58 percent.^[2]

 

 

The point that Dr. Harper was making while theoretically possible for a strike to cause the heart to cease beating, funciolnally it was impossible to do so on purpose.  The chance any strike can land on target in such a limited time as when the heart T-Wave reaches its peak in impossible for anyone to deliver on purpose.

 

To do such with intention is nothing short of serendipity.