The Buffalo Bills player who collapsed on the field and suffered a heart attack likely experienced a “very rare” life-threatening commotio cordis event, which is more common in youth sports that involve projectiles like baseballs and hockey pucks.

The Herald on Tuesday spoke with a Boston-area cardiologist, who stressed that a key message from this shocking event is to raise awareness about sudden cardiac arrest on the playing field, as he called for better training for CPR and defibrillators.

Bills safety Damar Hamlin remained in critical condition in the ICU a day after he was resuscitated on the field following a tackle in Monday night’s game against the Cincinnati Bengals. After making the tackle, Hamlin initially got up before suddenly collapsing backwards.

The 24-year-old defensive player suffered a heart attack, and club physicians and independent medical personnel performed CPR and used an automated external defibrillator to get his pulse back.

When local cardiologist Christopher Madias saw the impact to Hamlin’s chest and the resulting heart attack, the doctor thought of a life-threatening commotio cordis event.

“It’s a rare event because it really has to be the perfect storm of a series of unfortunate events for this to occur,” said Madias, cardiologist and director of the Cardiac Arrhythmia Center at Tufts Medical Center.

There has to be a major blow to the chest wall over the heart tissue, enough force to trigger this type of cardiac arrhythmia.

“The timing is critical,” Madias said. “There’s a very narrow window of vulnerability (within the heartbeat) when this can occur.”

Commotio cordis is more linked to youth sports that involve projectiles like baseballs, hockey pucks and lacrosse balls.

“These are very rare events for adult athletes because they have more developed chest walls, stiffer chest walls that are less prone to these type of events,” Madias said.

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