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Screening Young Athletes for Inherited Heart Defects

HCA Virginia Physicians June 20, 2017

Denise Dietz, MD

A young, college basketball player was rumored to be a potential top pick in the professional basketball draft. Yet, during a game midseason, he experienced arrhythmias (irregular rhythms of the heart's beating). He was removed immediately from the game and was treated. Three months later, during a tournament game, he collapsed and died. The cause of death was determined to be sudden cardiac arrest. Statistics show that this condition is rare, but that in many cases an underlying condition was already present. 

What Is Sudden Cardiac Arrest?

Sudden cardiac arrest in its simplest terms means an abrupt stoppage of blood flow when the heart stops beating effectively. Although there is usually no forewarning of a problem, symptoms can sometimes be missed or ignored. Symptoms might include:

  • Fainting spells
  • Chest pain
  • Shortness of breath

Sudden cardiac arrest is not the same as a heart attack. In a heart attack, the loss of blood supply causes heart muscle tissue to die. With sudden cardiac arrest, the body's electrical system becomes defective and the heart is not able to form an organized beat and rapid or chaotic activity occurs.

What Causes Sudden Cardiac Arrest?

Dr. Barry Maron of Tufts Medical Center in Boston was the lead investigator in a recent study that identified more than 2,400 sudden deaths between 1980 and 2011. The sudden deaths occurred among competitive athletes while participating in 29 different sports. The athletes were between the ages of 13 and 25, and researchers found that more than 840 of those deaths were heart-related.

In addition, the study found that:

  • Male athletes were 6.5 times more likely to die from sudden cardiac death than females.
  • Blacks and other minorities had death rates nearly five times higher from sudden cardiac death than white athletes.
  • Sudden cardiac death was three times more likely among minority male and female basketball players than white players.
  • Less than 5 percent of athletes who died had structurally normal hearts.
  • Certain heart problems were more common in female athletes who died suddenly. These included congenital defects in the heart's arteries and conditions that cause potentially dangerous irregular heartbeats.

In many cases that cause of sudden cardiac death was caused by the heart condition hypertrophic cardiomyopathy. This condition is often inherited and causes a portion of the heart's wall to grow abnormally thick, which hinders the heart's performance. There are often no symptoms.

Other causes of sudden cardiac death can include coronary artery abnormalities and myocarditis, an inflammation of the heart's muscular wall. Many of the athletes who died collapsed during or immediately after a training session, indicating that physical exertion appeared to trigger sudden death. Sudden cardiac arrest may also be caused by other conditions, such as:

  • Aortic stenosis—narrowing of the aortic valve
  • Inherited heart disease

Small Risk

Fortunately, sudden cardiac arrest in young, fit athletes is rare. Only a small percentage of sudden death cases occur in what appears to be overly healthy people who don't have any evidence of heart problems.

Screening Young Athletes to Prevent Sudden Cardiac Arrest?

The American Heart Association (AHA) recommends that young athletes be screened before participation in sports to determine their risk for sudden cardiac arrest. During the screening, the doctor will ask questions about whether the young person has a:

  • Personal history of chest pain or discomfort, fainting, heart murmur, or high blood pressure
  • Family member who has died or heart disease at an early age
  • Family history of heart conditions such as cardiomyopathy 

During the physical exam, the doctor will listen to the heart to check for a murmur, take a pulse rate and blood pressure reading, and look for other signs such as abnormal pulses or shortness of breath. Those athletes with positive findings should be referred for further evaluation and testing. In addition to these pre-participation screenings, schools, colleges, and professional teams should have personnel trained in CPR and have a defibrillator nearby in case of an emergency.

To locate a youth heart screening near you, visit http://www.screenacrossamerica.org.

If you have any questions regarding your heart health or general health, please reach out to Dr. Dietz, or one of our expert providers at HCA Virginia Physicians. You can book your next appointment online, and learn about our network of skilled practitioners.

Book An Appointment Online

Sources:

American Heart Association: www.heart.org
Screen Across America: http://www.screenacrossamerica.org

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