A young athlete participating in organized sports or heavy exercise dies from sudden cardiac arrest every 3 days in the United States. Put another way, that is less about 100 young athletes per year.
No matter how you consider these statistics, it’s devastating if it’s your child. The media will often cover these sad stories because they are so, seemingly, rare. No doubt you have read about these tragedies and wonder why they happen.
Let’s review the causes of sudden cardiac death in young athletes, and how they can be prevented.
Hidden Heart Abnormalities
Sudden cardiac death, or SCD, can be a result of several heart abnormalities which are underlying and unsuspected.
Hypertrophic-Cardiomyopathy is a genetic condition that thickens the walls of the heart leading to an irregular or fast heart beat. It happens to be the leading cause of sudden death in athletes under the age of 30. Unfortunately, it is usually undetected.
Long QT Syndrome is an inherited condition causing the heart to beat extremely fast. Fainting is a common sign of this condition and increases the risk for sudden death.
Abnormalities of the coronary artery significantly affect sufficient blood flow reaching the heart especially during exercise.
Other causes include: viruses or illnesses that result in inflammation of the heart, certain electrical problems in the heart, and being hit in the chest while playing sports, like with a hockey puck.
Common Risk Factors
There are some red flags to help parents and coaches be on alert:
- Fainting during exercise
- A family history of heart disease or death before the age of 50.
- Shortness of breath
- Pains in the chest
- Unusual fatigue
Preventing Sudden Cardiac Death
There are a number of ways to detect heart issues in young people through physical screenings.
Although it is common practice for athletes to undergo a pre-participation screening in high school and college, the process is not standardized. In 2017 the American Heart Association and the American College Of Cardiologists made recommendations to detect cardiovascular disease including genetic and congenital cardiac conditions.
The recommendations include 14 elements to review and evaluate in an athlete’s personal and family medical history.
Some of them are: history of a heart murmur, chest pains or discomfort while playing sports, hypertension, heart palpitations, unexplained fainting, and death of a near relative from a heart condition before the age of 50.
They did not recommend an EKG (electrocardiogram) for athletes without any of the risk factors or the 14 evaluated elements. Expense is a key factor here, so most organized sports do not mandate an EKG test. However, they did stress the importance of having an AED, or automated external defibrillator to respond to cardiac emergencies and prevent death.
Parents and coaches should be familiar with the risk factors and warning signs of an underlying cardiac issue. At least one portable AED should be available at every school along with a sufficient number of people who know how to use it properly.
Working together, we can help prevent sudden cardiac deaths in young athletes.
Talk to your child’s cardiologist at Children’s Heart Institute if your child exhibits any of the risk factors mentioned above.