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Explainer: What happened to Damar Hamlin?

Buffalo Bills quarterback Josh Allen (17) pauses as Damar Hamlin is examined during the first half of an NFL football game against the Cincinnati Bengals, Monday, Jan. 2, 2023, in Cincinnati.
Jeff Dean
/
AP
Buffalo Bills quarterback Josh Allen (17) pauses as Damar Hamlin is examined during the first half of an NFL football game against the Cincinnati Bengals, Monday, Jan. 2, 2023, in Cincinnati.

Buffalo Bills safety Damar Hamlin suffered a cardiac arrest after making a tackle during Monday night’s game, causing the NFL to suspend a pivotal game against the Cincinnati Bengals that quickly lost significance in the aftermath of a scary scene that unfolded in front of a national television audience.

“Damar Hamlin suffered a cardiac arrest following a hit in our game versus the Bengals. His heartbeat was restored on the field and he was transferred to the UC Medical Center for further testing and treatment,” the Bills said in a statement released early Tuesday. “He is currently sedated and listed in critical condition.”

The 24-year-old Hamlin was administered CPR on the field. Teammates surrounded Hamlin, shielding him from public view. Many were weeping and praying while Hamlin was treated on the field by team and independent medical personnel and local paramedics. He was taken by ambulance to University of Cincinnati Medical Center. Teammate Stefon Diggs later went to visit Hamlin at the hospital while fans of both teams gathered outside, holding lit candles and praying.

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What happened to Hamlin?

Hamlin was hurt while tackling Bengals receiver Tee Higgins on a seemingly routine play that didn’t appear unusually violent.

Higgins was running with the ball on a 13-yard pass from Joe Burrow when he led with his right shoulder, hitting Hamlin in the chest. Hamlin then wrapped his arms around Higgins’ shoulders and helmet to drag him down. Hamlin quickly got to his feet, appeared to adjust his face mask with his right hand, and then fell backward about three seconds later and lay motionless.

Hamlin was down for 19 minutes while receiving medical attention. WXIX-TV in Cincinnati reported that Hamlin required an automated external defibrillator (AED) in addition to CPR on the field.

What could have caused Hamlin's cardiac arrest?

Cardiac specialists say it’s too soon to know what caused Hamlin's heart to stop, but a rare type of trauma called commotio cordis is among the possible culprits. Commotio cordis occurs when a severe blow to the chest causes the heartbeat to quiver, leading to sudden cardiac arrest.

The condition only happens during a rare set of circumstances: when a sharp hit lands directly over the heart “at the exact wrong location at the exact wrong timing” during the heart’s rhythm cycle, said Dr. Rod Passman, director of the center for arrythmia research at Northwestern University’s Feinberg School of Medicine.

Commotio cordis occurs “probably 20 times a year,’’ and about 60% of those affected survive, said heart rhythm specialist Dr. Mark Link of UT Southwestern Medical Center. The main worry for survivors is brain damage from lack of oxygen when the heart stops pumping blood, Link said. Doctors can help reduce that risk with deep sedation to give the brain a rest, he said.

Dr. Aman Chugh, a University of Michigan cardiology professor, noted that hard-hitting tackles are extremely common in football and that commotio cordis is extremely rare. It could be that Hamlin had a pre-existing heart condition that caused his heart to stop, although that is speculative, Chugh said.

In general, underlying heart disease is the most common cause of sudden cardiac arrest, said Dr. Mariell Jessup, the American Heart Association’s chief medical officer.

“It is not uncommon to find out that very vigorous athletes have undiagnosed cardiac conditions even if they’re young players,” she said.

More than 365,000 people in the U.S. have sudden cardiac arrests in non-hospital settings each year, according to the American Heart Association. Survival depends on quick CPR and shocking the heart back into a normal rhythm, as reportedly happened with Hamlin.

“The teachable moment is learn CPR,’’ Jessup said.

Hamlin’s medical history has not been made public.