Children's Hospital Colorado

Sudden Cardiac Death in Young Athletes

A teenage boy in a black uniform runs on a track.

Fortunately, for your children and mine, sudden cardiac death on the athletic field is rare with approximately one death among every 100,000 to 200,000 athletes occurring each year. Because athletes are often regarded as the picture of health, sudden death events can lead to fear and confusion about how safe it is to participate in sports. Further, high media coverage about these deaths often causes worry far beyond the individual’s family or local community.

What are the causes of sudden cardiac death in young athletes?

Sudden cardiac death in young athletes is usually caused by an underlying condition. Some of these conditions include:

  • Hypertrophic cardiomyopathy (abnormal genetic thickening of the heart muscle)
  • Anomalous coronary arteries (congenital abnormalities involving origin, course, and structure of coronary arteries)
  • Commotio cordis (trauma to the chest causing disruption of heart rhythm)
  • Myocarditis (inflammation of the heart muscle)
  • Marfan Syndrome (disorder of connective tissue affecting the heart valves and blood vessels)
  • Arrhythmogenic right ventricular cardiomyopathy (genetic defect of the parts of heart muscle)
  • Dilated cardiomyopathy (condition where the heart becomes weakened and enlarged)
  • Structural heart disease (congenital abnormalities of the heart, heart valves, or blood vessels)
  • Ion Channelopathies (abnormalities of the heart’s electrical conduction system including the long QT syndrome and Brugada syndrome)

What is the best way to identify athletes at risk for sudden death?

There has been a lot of discussion among experts about the best way to proactively identify athletes at risk for sudden death. Many still feel the sports preparticipation history and physical examination (sports physical) remains the most practical method. While sometimes sudden death is the first sign of heart disease, many diseases that predispose individuals to sudden cardiac death are genetic and/or may cause clinical symptoms. We also know they can sometimes be identified by reviewing family history.

Making sure that every athlete has yearly screening examinations performed by an adequately trained practitioner using currently recommended guidelines is an important first step in identifying individuals at risk.

What should you do if an athlete suffers a cardiac event?

Rapid administration of CPR and cardiac defibrillation can often be life saving. If you witness a cardiac event on the athletic field you should:

  1. Begin CPR and call 911.
  2. Continue CPR until emergency medical services (EMS) arrives or an automated external defibrillator (AED) is placed on the victim. AEDs are self-explanatory lifesaving devices that are located in many public places including malls, schools, airports, etc. Find out more about AED’s on Colorado Red Cross website and search AED.

What more can I do?

  1. Learn CPR and encourage coaches and referees in your sporting leagues to become CPR trained as well. More information is available on the Colorado Red Cross website.
  2. Support organizations that are attempting to place AEDs in all schools across Colorado. (South Metro Safety Foundation, Kick Start My Heart Foundation, Brianna Badger Foundation, Dan Lunger Memorial Fund.) Visit the South Metro Safety Foundation website for more information about some of these organizations and an upcoming fundraising event can be found.
  3. Have your child undergo a sports physical exam every year and contact your primary care provider if you have any concerns about your child’s safety on the athletic field.

Read more articles for coaches of young athletes.

Written by: Christopher M. Rausch, MD, Director, Cardiopulmonary Exercise Laboratory, Assistant Professor of Pediatrics, Children’s Hospital Colorado and University of Colorado School of Medicine.

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