Sudden Death In Young Athletes Is Rare But Devastating

LEXINGTON, Ky. (July 31, 2012) — The following column appeared in the Lexington Herald-Leader Sunday, July 29.

Sudden death in young athletes

By Dr. Anna Kamp

Sudden cardiac death in young athletes is rare but devastating.

Although sudden cardiac death is reported to occur in less than five in 100,000 young people a year, incidents often make headlines and prompt parents to ask if there is anything they can do to prevent it.

Conditions known to be responsible for sudden cardiac death in athletes include hypertrophic cardiomyopathy, coronary artery abnormalities, diseases of cardiac electrical function, Marfan’s syndrome and other diseases of the heart muscle. Combined, these diseases are likely to occur in less than 0.5 percent of young athletes.

In recent years, there has been great controversy regarding appropriate cardiac pre-participation screening for young athletes. The American Heart Association recommends young athletes have yearly physical exams, including a detailed personal and family history. Some groups argue that all athletes should have screening electrocardiograms. However, screening electrocardiograms are not recommended by the heart association. It’s important to realize that the risk of sudden cardiac death is not excluded, even if an athlete has had a normal electrocardiogram and echocardiogram.

As a parent of a young athlete, the most important thing you can do is to improve the screening your child receives before participating in a sport:

• Make sure your young athlete pays attention to his/ her body. Does your child have repeated episodes of exertional chest pain, racing heartbeat or dizziness? Has your child passed out during exercise?
• Know your family history. Has anyone died suddenly from heart disease when they were younger than 50?
• Does anyone in your family have a specific diagnosis of Long QT, Brugada syndrome, or any cardiomyopathy? Do any family members have an implantable cardioverterdefibrillator?
• During your child’s sports screening visit, your physician will ask detailed questions about your child’s symptoms and your family history.

Additional evaluation might be warranted if any of the above is true.

Primary care physicians might refer your child to a pediatric cardiologist to ensure that he or she is competing in as safe a manner as possible. Additional evaluation might include an electrocardiogram , heart ultrasound , exercise stress testing or other cardiac imaging tests .

If your child has had concerning symptoms or there is a family history of sudden cardiac death, make an appointment with your young athlete’s physician.

Dr. Anna Kamp is a pediatric electrophysiologist at Kentucky Children’s Hospital.