How to Lessen the Risk of Sudden Cardiac Death in Young Athletes

(A checklist for parents and young athletes to review prior to playing competitive sports)

There are few things more devastating than to learn that a young athlete has collapsed and died. Even though it is extremely rare, sudden cardiac death is a frequent cause of sports-related death in young athletes. By conducting a thorough exam and screening, your pediatrician can help play an important role in lessening the risks and hopefully preventing this potentially life-threatening event.

The first goal is to identify problems your child or teen may have

Mason Gomberg, MD

Before your child starts any sport, it’s important to make the coaching staff aware of any health issues or conditions your child has, as well as any medications or supplements your child is taking.

Health issues that might predispose your child or teen to sudden cardiac death include:

  • exercise-induced asthma
  • previous history of concussions
  • scoliosis (as a sign of Marfan syndrome)
  • female athletic triad (an eating disorder causing weight loss, amenorrhea/loss of menstruation and/or decreased bone density)

For young athletes, dehydration is a serious concern

On very hot days, all athletes need extra water and longer rest periods between workouts. An easy way to monitor for dehydration is to have your child’s coaching staff perform daily and midday checks. A child with a sickle cell trait is much more prone to the effects of dehydration.

According to AboutKidsHealth, the common signs and symptoms of dehydration are:

  • dry, cracked lips and a dry mouth
  • moderate to severe muscle pain and cramps
  • not sweating when hot and exercising
  • vomiting
  • rapid heart rate at rest
  • a decrease in urine output/no urine for 8-12 hours/dark-colored urine
  • drowsiness
  • irritability
  • cold or dry skin
  • low energy levels, seeming very weak or limp
  • no tears when crying
  • sunken eyes or sunken soft spot (fontanelle) on a baby’s head

Protective gear can help

To prevent the sudden impact of a baseball or softball hitting an athlete’s chest, many little leagues are now requiring a chest protector type of device to be worn under a young athlete’s shirt. In extremely rare cases, the striking of the chest bone with a high-velocity ball can cause an arrhythmia that leads to collapse and death. Any sport that includes high impact balls colliding with a child’s chest wall should require some protection.

Questions for athletes from the American Heart Association

The following is a list of question from the American Heart Association that should be asked competitive athletes during a pre-participation heart screening:

Is there a personal history of:

  1. chest pain/discomfort, pressure with exertion
  2. unexplained fainting
  3. excessive or unexplained fatigue, palpitations, shortness of breath associated with exercise
  4. prior heart murmur
  5. elevated blood pressure
  6. prior restriction from sports participation (including any previous cardiac testing

Is there a family history of:

  1. Premature sudden death attributed to heart disease in someone under age 50 (sometimes an unexplained accident in a car or drowning is an unexplained or unknown cardiac issue)
  2. Disability from cardiac disease in a relative under the age of 50
  3. Hypertrophic or dilated heart, cardiomyopathy, long QT syndrome or other significant arrhythmias, or specific genetic cardiac conditions including Marfan syndrome

If you answered yes to any of these questions, YOUR CHILD’S DOCTOR NEEDS TO KNOW. At the very least, he/she may refer your child to a pediatric cardiologist. At the very most, your child’s life may be saved!

To learn more

For more information on Sudden Cardiac Death, you might find these articles helpful:

If you’re concerned about your young athlete’s risk of Sudden Cardiac Death, please come see us

If you have a child or teen who participates in sports and you’re concerned about sports-related heart conditions, specifically Sudden Cardiac Death, please make an appointment with Westchester Health Pediatrics to see one of our pediatricians. We’ll examine your child and together with you, determine if any preventative measures or treatment needs to be taken. If we feel it’s needed, we will refer your child to a pediatric cardiologist for more specialized evaluation and treatment. Whenever, wherever you need us, we’re here for you.

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By Mason Gomberg, MD, a Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners