Young Athletes and Sudden Cardiac Arrest

Added by Katie Boushie on February 19, 2013.

Abrupt and life threatening, Sudden Cardiac Arrest (SCA) is the leading cause of death in young athletes. Because they are often assumed to be healthy, it can be a complete surprise when a child athlete has a SCA. What could trigger an otherwise healthy looking individual to fall into Sudden Cardiac Arrest?

Often the arrest is caused by an underlying heart abnormality that was never diagnosed. This may include; an enlarged heart muscle, enlarged coronary artery, irregular heart rhythms, or several heart diseases. Unfortunately, many athletes have no symptoms until the SCA, making it essential that health care professionals are prepared for this unpredictable event. Athletes without any symptoms are not required to undergo any cardiovascular screening prior to participating in a sport. Screenings are often expensive, insensitive, and do have a chance of producing a false-positive result. However; any cardiac symptoms should never be ignored or taken lightly.

Cardiac abnormalities make up the majority of SCA triggers, but do not account for all. Approximately 2% of deaths due to SCA never have an identifiable cause of death. The remaining estimated 20% are caused by Commotio Cordis. This is a result of a blow to the chest, such as from a baseball, that causes arrhythmia. The blow must occur at a specific point in the heart beat, and is more common at speeds exceeding 35 miles per hour. While very rare, it can be deadly if not immediately treated with CPR and an AED. Some precautions can be taken to decrease chances of Commotio Cordis; such as, proper protective gear, not stepping in front of a ball to stop it, and discouraging adults from throwing at full strength to children because of the increased speed and force.

Sudden Cardiac Arrest is a very scary health concern. In 2003 the nationwide survival rate from SCA was only 5%. Automated External Defibrillators can increase the survival rate up to 74%. Keep in mind, these numbers are not specific to young athletes and do include the elderly. All sports should have a health care professional and an AED on site. Following Sudden Cardiac Arrest, survival rate decreases 7-10% for every minute until CPR is initiated; once CPR is started survival rates decrease 3-4% every minute until an AED is used. The highest chances of survival are found when defibrillation (AED) occurs within three to five minute of the athlete collapsing. Because of the time-sensitivity with reacting to Sudden Cardiac Arrest, all schools should have an emergency plan and AED in place prior to the event, with an Athletic Trainer ready to act.