by Asp K

Cardiac Arrest in Healthy, Young Athletes

IMAGE A young, college basketball player was rumored to be a potential top pick in the professional basketball draft. Yet, during a game midseason, he experienced arrhythmias (irregular rhythms of the heart's beating). He was removed immediately from the game and was treated. Three months later, during a tournament game, he collapsed and died. The cause of death? Sudden cardiac arrest. Other athletes, professionals and amateurs, have taken to the field only to meet a fatal defeat. Statistics show that this condition is rare, but what is sudden cardiac arrest? And why has it taken the lives of such strong, healthy athletes?

What Is Sudden Cardiac Arrest?

softball thumb Sudden cardiac arrest in its simplest terms means an abrupt cessation of the blood flow when the heart stops beating effectively. Although there is usually no forewarning of a problem, symptoms can sometimes be be missed or ignored. Symptoms might include fainting spells, chest pain, or shortness of breath.
Sudden cardiac arrest is not the same as a heart attack. In a heart attack, the loss of blood supply causes heart muscle tissue to die. With sudden cardiac arrest, the body's electrical system becomes defective and the heart is not able to form an organized beat and rapid or chaotic activity occurs.

What Causes Sudden Cardiac Arrest?

In one of the largest studies of sudden cardiac arrest, researchers examined 158 sudden deaths that had occurred in trained athletes throughout the United States between 1985 and 1995.
More than half of the athletes competed at the high school level, one-fourth competed at the collegiate level, and a small percentage were professional athletes. Basketball and football accounted for the largest percentage of sports. Other sports included track, soccer, baseball, swimming, volleyball, ice hockey, boxing, crew, ice skating, tennis, and wrestling.
Of those 158 athletes, the majority suffered from cardiovascular causes of sudden death. The most common cause was hypertrophic cardiomyopathy, which is an inherited condition that causes the left ventricle to be abnormally thick. Other causes of sudden cardiac death in this study included coronary artery abnormalities and myocarditis, an inflammation of the heart's muscular wall. Researchers reported that the majority of the athletes collapsed during or immediately after a training session, indicating that physical exertion appeared to trigger sudden death.
Sudden cardiac arrest may also be caused by other conditions, such as:.

Small Risk

Fortunately, sudden cardiac arrest in young, fit athletes is rare. Only a small percentage of sudden death cases occurs in what appears to be overly healthy people who don't have any evidence of heart problems.

Can Anything Be Done to Prevent Sudden Cardiac Arrest?

The American Heart Association (AHA) recommends that young athletes be screened before participation in sports to determine their risk for sudden cardiac arrest. During the screening, the doctor will ask questions about whether the young person has a:
  • Personal history of chest pain or discomfort, fainting, heart murmur, or high blood pressure
  • Family member who has died or heart disease at an early age
  • Family history of heart conditions such as cardiomyopathy
During the physical exam, the doctor will also listen to the heart to check for a murmur, take a pulse rate and blood pressure reading, and look for other signs such as abnormal pulses or shortness of breath. In addition to these preparticipation screenings, schools, colleges, and professional teams should have personnel trained in CPR and have a defibrillator nearby in case of an emergency.

RESOURCES

American Heart Association http://www.heart.org

Sudden Cardiac Arrest Association http://www.suddencardiacarrest.org

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

Canadian Society of Exercise Physiology http://www.csep.ca/

References

American Heart Association. Cardiovascular preparticipation screening of competitive athletes. Med Sci Sports Exerc. 1996;28:1445–1452.

Cardiac arrest. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 14, 2013. Accessed January 16, 2014.

Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular pre-participation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association. Circulation. 1996;15;94(4):850-6.

Preparticipation cardiovascular screening for athletes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated August 23, 2012. Accessed January 16, 2014.

10/12/06 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006;296(13):1593-601.

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