Understand and Prepare for Sudden Cardiac Arrest Before An Emergency OccursSudden Cardiac Arrest (SCA) is caused by sudden failure of proper heart function during or immediately following exercise. This often occurs with no known trauma. Since the heart loses its ability to effectively pump blood, the athlete quickly loses consciousness and will die. To stop this tragic cascade of events, normal rhythmical pumping of the cardiac muscle must be quickly restored using an automated external defibrillator (AED).
How Often Does SCA Occur and Who is Most at Risk?Fortunately this tragic event is considered rare, happening about 100 reported times per year in the United States. The chances of a high school athlete suffering frame SCA is reported to be 1:200,000. SCA is more common in males, football, swimming and basketball and in African-Americans than in other races.
Heart Problems Are Difficult to Detect in High School AthletesTypically, the athlete presents no symptoms of cardiac problems. The problem is caused by one or several cardiovascular abnormalities and electrical diseases of the heart that go unnoticed in healthy-appearing athletes. The most common cause is hypertrophic cardiomyopathy (HCM) which is an enlargement (hypertropci) of the heart muscle (myopathy) producing a thickening of the heart muscle which can cause serious heart rhythm problems and blockages to blood flow. The second cause is congenital abnormalities of the coronary arteries.
Warning signs to watch for include:
- Fainting, seizure or convulsions during physical activity
- Fainting or seizure from emotional stress or excitement
- Dizziness during exercise
- Chest pains at rest or during exercise
- Heart palpitations (skipping beats, irregular beats) during exercise or cool down periods after exercise
- Fatigue or tiring more quickly than others or than expected
- Shortness of breath limiting physical exertion
What steps can be taken to prevent tragedy during the annual pre-participation examination?
- Parents and athletes should provide information to the examining physician about any experience with the signs and symptoms listed.
- History of family members who died suddenly during or after exercise.
- Any family member under the age of 50 experiencing sudden death in car accidents or drownings (unexplained heart stoppage may produce fainting or death an inopportune times).
Is There Any Tests That Can Detect These Heart Conditions?Dr. Mark Russell, a pediatric cardiologist at the University of Michigan's C.S. Mott Children's Hospital, said no one screening test is able to detect the "several different heart conditions that can cause sudden death in a young athlete." EKGs may catch some defects, the echo others, while other problems may only be revealed in an exercise stress test.
How Can I Protect My Athletes?Since detection can be elusive, consider the places where your athlete engages in activity - the swimming pool, the field, the gym, the weight room, the visitor's field - and consider having an AED available in these places to protect from the unexpected.
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Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.