Posts Tagged ‘sudden cardiac arrest’

Sudden Cardiac Death in Young Athletes

football250x250Sudden death in young people, often due to hidden heart defects or overlooked heart abnormalities, is rare. Of the 360,000 sudden cardiac arrests that occur in the United States each year outside of hospitals, very few occur in young people and only some of those young people die of sudden cardiac arrest. When these tragic sudden cardiac deaths do occur, it’s often during physical activity, such as participating in an athletic event or strenuous exercise.

Causes

The causes of sudden cardiac death in young people vary, but most of the time deaths are due to heart abnormalities, such as unrecognized inherited heart disease (example, hypertrophic cardiomyopathy) and coronary artery abnormalities. Other causes include inherited heart rhythm disorders such as Long QT syndrome, Brugada syndrome, or other inherited cardiac “channelopathies”.

Additional etiologies include inflammation of the heart muscle (myocarditis), which can be caused by viruses and other illnesses. Sudden cardiac death can also occur as the result of a blunt blow to the chest, such as being hit by a baseball or hockey puck, at just the right time (commotion cordis). The blow to the chest can trigger ventricular fibrillation if the blow strikes at exactly the wrong time in the heart’s electrical cycle.

Don’t Ignore the Warning Signs

What can young athletes do to prevent a sudden cardiac event? In more than a third of these sudden cardiac deaths, there were warning signs that were not reported or taken seriously. In particular, symptoms that occur during exercise should always be taken seriously. Here are the typical warning signs:

  • Fainting during physical activity;
  • Dizziness or lightheadedness during physical activity;
  • Chest pains or tightness, at rest or during exertion;
  • Palpitations – skipping, irregular or extra beats during athletics;
  • Being unable to keep up with peers due to shortness of breath or noted loss of exercise tolerance

Preventing Sudden Cardiac Death

A proper evaluation should find most, but not all, conditions that would cause sudden cardiac death in the athlete. Some diseases are difficult to uncover while others can be diagnosed following a normal guideline-based screening evaluation.

The required physical exam includes measurement of blood pressure, a careful listening examination of the heart, and palpation of the peripheral pulses. If there is concern for a condition associated with a higher risk of sudden cardiac death, further evaluation guided by the sports cardiologist would continue and frank discussions regarding the appropriate “exercise-prescription” would take place. These discussions would include the risk profile for ongoing competitive athletics.

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About Dr. Jonathan Kim, MD

kim-jonathanDr. Kim is an Assistant Professor of Medicine at the Emory Heart and Vascular Center. He graduated from Vanderbilt University School of Medicine, Nashville, TN, and did his residency at Massachusetts General Hospital, Boston, MA. His specialties are Cardiology (Board certified since 2014) and Internal Medicine (Board certified since 2008) and his area of clinical expertise is sports cardiology. He has developed a new sports cardiology clinic at Emory-St. Joseph’s Hospital.

New Treatment Available at Emory for the 850,000 U.S. Adults at Risk for Sudden Cardiac Arrest

New Treatment Cardiac Arrest RiskEmory University Hospital Midtown and Emory University Hospital in Atlanta are among the first hospitals nationwide and the only hospitals in Georgia to have access to the world’s first and only commercially available subcutaneous implantable defibrillator (S-ICD) for the treatment of patients at risk for sudden cardiac arrest (SCA).

Emory has been a part of the clinical trials to get this device approved and was the third highest enrolling center nationwide. Electrophysiologist Michael Lloyd, MD will be performing the procedure for the first time since the device has been approved on the open market on November 12, 2012.

The S-ICD System, produced by Boston Scientific, is designed to provide the same protection from SCA as transvenous implantable cardioverter defibrillators (ICDs); however the S-ICD System sits entirely just below the skin without the need for thin, insulated wires – known as electrodes or ‘leads’ – to be placed into the heart itself. This leaves the heart and blood vessels untouched, offering physicians and patients an alternative treatment to transvenous ICDs.

Sudden cardiac arrest is an abrupt loss of heart function. Most episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia or ventricular fibrillation. Recent estimates show that approximately 850,000 people in the United States are at risk of SCA and indicated for an ICD device, but remain unprotected.

Emory Electrophysiologists Mikhael El Chami, MD, Michael Hoskins, MD, Angel Leon, MD, David DeLurgio, MD, Jonathan Langberg, MD and Michael Lloyd, MD have been instrumental in getting this device approved and will be performing this procedure.

Dr. Michael LloydAbout Michael Lloyd, MD:
Dr. Lloyd began practicing medicine at Emory in 2007—he specializes in Cardiology and Cardiac Electrophysiology. His areas of clinical interest and research include arrhythmias, electrophysiology lab, and pacemaker. Dr. Lloyd’s organizational leadership memberships include the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society.

 

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Take-Aways from Cardiac Arrest Web Chat

Sudden Cardiac Arrest in Young AthletesThank you for those who were able to participate in the Emory Heart & Vascular Live Chat on Cardiac Arrest in Young Athletes. I was very impressed by many of your questions on the topic of cardiac arrest, and happy to be able to answer them. If you were not able to join me, you can view the Sudden Cardiac Arrest chat transcript here.

In the chat, we covered a variety of important topics pertaining to cardiac arrest symptoms, warning signs, and risk factors. All parents, coaches, and supporters of young athletes should be aware of these warning signs and know how to respond when they present themselves. There are a few key takeaways from last week’s chat that I would like to reiterate:

  1. Children and adults can survive sudden cardiac arrest if parents and others in the area act quickly.
  2. We encourage all coaches and parents learn CPR.
  3. In addition, we recommend obtaining an AED for all sports facilities. The equipment can be costly, but can save the life of a young athlete.

During the chat, there was also a question regarding what sports/activities were deemed too strenuous for those with heart disease. Please refer to the chart below that outlines the classification of competitive sports. The acceptable competive sports for those patients who have been diagnosed with hypertrophic cardiomyopathy and most other types of heart disease are:

    • Billiards
    • Bowling
    • Cricket
    • Curling
    • Golf
    • Riflery

Please note that if you think you could be at risk for HCM you should visit your primary care physician for an evaluation. If the physician clears you or your child you do not need to limit activity based on the above chart.

If you have additional questions about sudden cardiac arrest in general, or cardiac arrest in young athletes, please use the comments section below. Please also feel free to use the comments section to let us know if you have other heart and vascular topics you would like to cover in future live chats!

Thanks again for a great chat!

Author: B. Robinson Williams, III, M.D.

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