Protecting Young Athletes From Sudden Cardiac Arrest

February 02, 2023

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

Energetic preteen and teenage male footballers cheering and punching the air as they run onto field for training session

Sudden cardiac arrest (SCA) occurs when the heart suddenly stops beating normally, causing a person to collapse and pass out. SCA is rare in young people. So, it’s jarring when you hear about a case happening, whether to a young athlete or the SCA experienced by NFL Bills player Damar Hamlin.

“If you’re the parent of a young athlete – or any active child or teen – it’s not surprising if you feel concern,” says James Strainic, MD, Director of Outpatient Pediatric Cardiology and the Fetal Heart Program at University Hospitals Rainbow Babies & Children’s. “It’s a scary topic, but there are steps you can take to reduce the risk.”

Here’s what you need to know.

Be Aware of SCA Risk Factors

It is possible for SCA to occur in a young athlete with a normal heart. A blow to the chest at a precise point in the heartbeat cycle could lead to something called commotio cordis, which causes the heart to stop. This is very rare.

SCA can also be caused by myocarditis, or inflammation of the heart muscle, usually due to a virus. Most cases of SCA in young athletes, however, are associated with a preexisting heart problem. “A leading cause in the United States is hypertrophic cardiomyopathy,” explains Dr. Strainic. “This condition is usually inherited. It can cause an abnormal heart rhythm, particularly during exercise.”

While hypertrophic cardiomyopathy can often go undetected until a severe issue occurs, you can help your child’s pediatrician find it sooner by sharing your child’s health and family history.

Dr. Strainic advises that parents and caregivers let their pediatrician know if the child has:

A relative with an inherited heart muscle or electrical problem
A relative with unexplained SCA at a young age (under age 50)
Chest pain during exercise
Fainting or a seizure during exercise
A congenital (present at birth) heart defect
Marfan syndrome or a family history of an aortic dissection (a tear in the main body artery)

Most kids with risk factors can still take part in a variety of sports and physical activities. Ask what’s right for your child and whether there are any limitations.

Take Well-Child Visits and Sports Physicals Seriously

Pediatricians will routinely ask questions to screen for SCA risk as part of well-child visits. All children and teens should get plenty of exercise, whether they play on a sports team or not.

“I highly recommend that you see your pediatrician for your child’s sports physical, they know your child best. The sports physical that is often required before your child can participate in an activity is one of the best ways to help your child participate safely,” says Dr. Strainic.

Children participate in many activities that may not be considered a “sport.” You can also request a sports physical for your child or teen, whether they play on a little league team, skateboard at the park or march in the band.

Prepare for the Unexpected

SCA is uncommon in kids, but if it does occur, Dr. Strainic emphasizes the need to act quickly and decisively.

Know the signs of SCA:

Sudden loss of responsiveness. The person doesn’t react at all, even if you tap them firmly on the shoulder or ask loudly if they’re OK.
Lack of normal breathing. The person isn’t breathing or is only gasping for air.

If these signs occur, call 9-1-1 first. Then, while waiting for help to arrive, start CPR and, if available, use an automated external defibrillator (AED).

An AED is a portable device that sends a shock to the heart to help restore its normal rhythm. Many public places, such as schools and gyms, now keep an AED on hand. You don’t need any special training to use one since they provide easy-to-follow voice prompts that guide you through the process.

A number of states also have laws that require school personnel, health club employees and others to know the risks and signs of SCA. Lindsay’s Law in Ohio is one example. In addition to education, it requires a student who has shown specific signs of SCA risk (such as fainting during an athletic activity) to be cleared by a physician before they can participate again.