Sudden Death in Young Athletes

Stephanie H. Kong, M.D., and David Jones, M.D., Pediatric Cardiologist

The public’s view of student athletes is that they are gifted, strong, healthy and even good looking. That may be true on the outside but a few of them, without warning or previous symptoms, (even while playing in the backyard), die suddenly. It occurs five times more frequently for boys.

As rare as it is, when it happens, it grabs the public’s attention. It is a highly visible tragedy. While the incidence of sudden cardiac death is greater in athletes compared with their non-athletic counterparts due to the increased risk associated with strenuous exercise, there are lots of structural, electrical, and other causes. Most of these causes can be diagnosed and medically managed but considering the number of kids playing sports, cardiovascular screening is not feasible and almost never done. While there are challenges when evaluating athletes for early diagnosis and treatment of pathological conditions, the best pediatricians continuously monitor their patient’s health status.

If parents are deliberate about their children’s well child checks, it is far more likely that pathological conditions will be picked up and immediately referred to a Pediatric cardiologist. Pediatricians are diligent about identifying enlarged hearts, irregular beats and platelet aggregation.

Even though it is not mandatory (due to cost), we recommend the pre-participation sports screening recommended by the AHA and the NCAA, to include a 12-point screening protocol encompassing symptoms, family history, and physical examination. Incorporating ECG into a screening protocol improves efficacy in identifying conditions capable of causing sudden death. The incidence of hypertrophic cardiomyopathy, a disease in which the heart muscle becomes thick and impedes blood flow is about one in 4,000.

This article is in no way intended to discouraged exercise or participation in sports. We wholeheartedly support and encourage both.

In case a student or even an excited parent, in the bleachers have cardiac arrest, survival is greatly improved by prompt recognition, the presence of trained medical personnel to initiate CPR, as well as access to an automated external defibrillator. Even if the worst happens, with proper preparation, two thirds of those affected will survive.

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