Over the past twenty-five years, the topic of Sudden Cardiac Death in young athletes has become one of concern and debate. Sudden Cardiac Death is a broad term used to describe the death of an individual from any unexpected failed heart function usually during or after physical activity from a non-violent or non-contact event. While it is not considered a common occurrence, it is a very traumatic and difficult thing to coupe with, not just for the family, but also the team, coaches, medical staff, and community. There has been a big push in recent years to find the cause; underlying signs, symptoms, and risk factors; ways to prevent it; and proper screening techniques of Sudden Cardiac Death in the hopes of tragedies being avoided.
One of the biggest questions that we are asked is "what is causing young, healthy athletes to suddenly die during and after physical activity with no real signs or symptoms of dysfunction or disease?" According to recent research, there are approximately twenty causes leading to the loss of proper heart rhythm, or ventricular fibrillation that can end up resulting in Sudden Cardiac Death. A few of the most common causes include hypertrophic cardiomyopathy, coronary artery abnormalities, and myocarditis. Hypertrophic cardiomyopathy, HCM, is an abnormal thickening of the left ventricular wall causing arrhythmia, or blockage to blood flow. HCM is genetic and can be diagnosed with an echocardiograph, or ECG. Myocarditis is the acute inflammation of the heart due to an infection called Coxsackie B virus. Many times the virus can present itself as a typical viral illness with symptoms of vomiting, fever, nausea, and diarrhea. In order to diagnose myocarditis, a physical exam and myocardial biopsy should be done.
Along with the causes of Sudden Cardiac Death, the signs, symptoms, risk factors and ways to prevent it, are also important to know. While most of the time deaths happen without warning, there sometimes may be signs and symptoms that can be associated with it include unexplained fainting, also known as syncope, during physical activity and a family history of cardiac death. By knowing basic signs and symptoms, as well as utilizing pre-participation exams, Sudden Cardiac Death can sometimes be avoided if any red flags are caught early enough.
Pre-Participation physicals or pre-participation athletic evaluations (PAE) have become more popular among high schools and universities across the country for the predetermination of medical abnormalities. The American Heart Association has since created recommendations of items to add to PEAs. These items include questions about family history of premature death or sudden death or heart disease; personal history of heart murmurs, systemic hypertension, excessive fatigue, exertional chest pain, exertional syncope, or excessive shortness of breath; a physical assessment for heart murmur, femoral pulses, stigmata of Marfan Syndrome, and brachial artery blood pressure; and parental verification of personal and family history for high school athletes. Along with the American Heart Association’s recommendations, many athletic programs have also added the use of screening instruments like electrocardiograms (EKG, or ECG) which record the electrical signals of the heart. The down fall to instrument screening is it can sometimes lead to false-positive results for heart conditions causing premature worry and more expensive tests. As recommended by the American Heart Association the best way to identify possible risks for cardiac problems leading to Sudden Cardiac Death is getting a thorough medical history of both the individual and their family and a physical exam by a physician.
While Sudden Cardiac Death may be rare, it is still a devastating thing to experience, but if the proper steps are taken before, the risk of it happening decrease greatly. So always remember to know your family history and see a physician at least once a year. We also encourage you to see a physician for any episodes of fainting, racing heartbeat, shortness of breath, or chest pain or tightness. You may think it is nothing, but the life you save could be your own!