By Michael A. Smith, MD
But summer also means high school football and those dreaded two-per-day practices. And unfortunately, nearly every year, we hear about a young athlete succumbing to sudden cardiac death. It’s a horrible tragedy that saddens and scares us all.
When we hear about it, we start to question everyone involved. Were the coaches working them too hard? Should teenagers even have two-per-day practices in the middle of summer? Did the family doctor miss something during a physical?
These are all legitimate questions and probably should be investigated.
But as a medical doctor, I always think to myself, “Did this child ever have symptoms indicating a heart problem?” A great way to answer this question is to investigate cases where the young athletes were successfully resuscitated and are alive today.
Identifying the warning signs and symptoms of sudden cardiac arrest could help parents and doctors recognize a potentially life threatening heart condition.
And that’s exactly what researchers at several U.S. medical centers did last year. Their findings were published recently in the Journal of the American Board of Family Medicine.
Let’s take a look at what they discovered about sudden cardiac arrest in young athletes.
Are the Warning Symptoms of Cardiac Arrest Detectable?Here’s the researchers’ hypothesis: “Young adults with undiagnosed cardiovascular disorders at risk for sudden death may have warning symptoms or significant family history that is detectable through screening.”1
Their objective was to determine the prevalence of warning symptoms by looking into the histories of children and young adults who suffered sudden cardiac arrest (SCA). They conducted a retrospective survey investigating the study subjects’ past medical and family history for anything that might indicate a serious heart condition.1
Eighty-seven of 146 families completed the survey. The average age of the kids who suffered SCA was 16 years old and 69% were boys, and 68% white. Seventy-two percent of SCA victims were reported by their parents to have a least one cardiovascular symptom within 2 ½ years of suffering sudden cardiac arrest. The most common cardiovascular symptoms reported were:1
- Generalized fatigue — 44%
- Lightheadedness — 30%
- Family history of SCA before age 50 — 27%
- One or more episodes of passing out or unexplained seizure — 24%
What You Need to KnowThe authors concluded: “Many children and young adults who suffered SCA are reported to have cardiac symptoms or a family history of premature cardiac death. Syncope [passing out] and unexplained seizure activity are distinct events but often go unrecognized as ominous signs of underlying cardiovascular disease.”
What we’ve learned from this study is that warning symptoms precede SCA and there’s usually a family history. Generalized cardiovascular screening for all young athletes is probably not necessary if parents, coaches and doctors simply ask specific, probing questions for symptoms of fatigue and lightheadedness. Parents should investigate family histories for premature deaths as well.
If you suspect something is wrong, speak with your doctor. Maybe a cardiac stress test is warranted; maybe nothing needs to be done.
But the point we're making is this: Sudden cardiac arrest is often not so “sudden” in terms of warning symptoms. We just need to ask the right questions and run the right tests, if necessary.
- J Am Board Fam Med. 2012; 25(4):408-15.
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