Commotio cordis: the rare cardiac condition linked to Jesús de Miguel's death on the pitch

Jesús de Miguel, a player for CD Tenerife, died following an incident during a Spanish Segunda División match against FC Andorra. While no official statement has confirmed the cause of death, reports have pointed to commotio cordis — a rare but medically recognised condition in which a blow to the chest triggers sudden cardiac arrest.

The term commotio cordis translates literally as “agitation of the heart.” The condition was first described by doctors in the 1850s, and in 1932 researchers in Germany identified three key factors that determine its likelihood: the type of impact, its speed, and the precise location on the chest where it lands. A sudden, sharp blow is considered particularly dangerous.

The heart sits inside the chest, shielded by the ribs and the sternum. Unlike skeletal muscle, it contains specialised cells that generate their own electrical signals, allowing it to beat continuously without conscious effort. Between each contraction, those cells undergo a carefully timed electrical reset — a phase visible on an electrocardiogram as the T-wave — during which they prepare to fire again.

For commotio cordis to occur, an impact must land during a very specific moment within that reset phase. The vulnerable window lasts approximately 30 milliseconds — just three hundredths of a second. A blow during that narrow interval can disrupt the heart’s normal electrical rhythm and trigger ventricular fibrillation, one of the most dangerous cardiac events known to medicine.

In ventricular fibrillation, the heart’s lower chambers stop contracting in a coordinated way and instead quiver chaotically. Blood can no longer circulate effectively to vital organs, including the brain, causing cardiac arrest — a state in which the heart ceases to pump blood properly and the person loses consciousness rapidly.

The condition is most commonly associated with sports involving projectiles or physical contact, where a ball, puck, or body part can strike the chest at high speed. Because the timing required is so precise, commotio cordis is statistically rare, but it is well documented in medical literature and has been reported across a range of sports at all levels of competition.

No official confirmation of the cause of De Miguel’s death had been issued at the time of publication.