Sudden Cardiac Arrest is the leading cause of death in youth sports, according to the recent Youth Sports Safety Summit. It’s a frightening reality that many parents and coaches fear, but don’t necessarily understand.
Sudden Cardiac Arrest occurs when the heart’s normal rhythm becomes severely abnormal, compromising cardiac output. These arrhythmias can be generated by a number of triggers, including direct blunt trauma to the chest or exertion stress upon a previously unrecognized vulnerable heart.
Blunt trauma is often the result of an object such as a baseball or hockey puck striking a child in the chest during the very brief period of electrical vulnerability associated with each normal heartbeat—resulting in ‘commotio cordis’, a life threatening arrhythmia that often degenerates into fatal ventricular fibrillation. Appropriate protection equipment or alternate types of baseballs/pucks can reduce the morbidity and mortality of chest trauma in young athletes.
When sports participants experience arrhythmias during exertion stress, it is often associated with previously unrecognized conditions such as hypertrophic cardiomyopathy (a thickened left ventricle usually present via congenital route). Since the cardiomyopathy results in some compromised left ventricular function, an increase in hemodynamic demand places an extra burden on the abnormal heart muscle substrate. This extra burden renders the heart vulnerable to disturbances in electrophysiology, with an increased risk of severe arrhythmias. Hypertrophic cardiomyopathy can be detected by ECG screening, with follow up echocardiography where warranted.
Since screening all children for heart pathophysiology is not practiced in our current health care system, directives from the summit encourage Coaches, teams and schools to implement a strong cardiac chain of survival:
- Recognize a cardiac emergency and call 911
- Early CPR
- Early defibrillation
- Early advanced cardiac life support
While we run electrophysiology studies to make sure drugs are safe and do not cause sudden cardiac death, we continue to learn more about the condition along the way.
You want may want to checkout www.parentheartwatch.org for more information.
Filed under: Atrial Fibrillation, Electrophysiology, Hemodynamics | No Comments