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What Causes Sudden Death in Youth Athletes?

Sudden death in young athletes often caused by congenital heart disease

By , About.com Guide

Updated February 24, 2013

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Sudden death in young athletes, while rare, is often a sobering reminder of the importance of basic safety precautions for every young athlete who participates in organized sports. While not every death can be prevented, there are precautions that may minimize the risk of death and serious injuries.

What Causes Sudden Death in Athletes?

The vast majority of sudden death in young athletes is due to an underlying heart condition. The two most common of these include:

  1. Hypertrophic Cardiomyopathy (HCM)
    Hypertrophic cardiomyopathy, or an enlarged heart, is a condition that causes the heart muscle to thicken, which makes it harder to pump blood efficiently. In a young athlete, hypertrophic cardiomyopathy is most often an inherited condition.

  2. Congenital Abnormalities in the Coronary Arteries
    Some kids are born with an abnormal coronary artery which has a sharp angle and may actually form a "kink" during strenuous exercise. This kink can severely restrict blood flow to the heart during intense exercise.

In both of these cases, intense physical exertion may trigger a lethal cardiac arrhythmia called ventricular fibrillation, which may lead to sudden death.

Commotio Cordis and Sudden Death

Another rare cause of sudden death in young athletes is Commotio Cordis. This occurs when a sudden, intense blow to the chest disrupts the heart rhythm and causes a cardiac arrest. Statistics show that this injury occurs more frequently in athletes playing hockey, lacrosse, baseball or football.

Preventing Sudden Death in Athletes

While some risk factors for sudden death or cardiac events may be discovered by reviewing the family history and undergoing a simple sports physical, many experts argue that today's mandatory sports physicals are inadequate for finding potentially lethal heart conditions.

Many sports physicians recommend that in addition to the basic sports physical, student athletes also need to have a cardiac physical. The cardiac physical includes the following three assessments:

  1. A review of a family history of cardiac disease
  2. An electrocardiograph (ECG)
  3. An echocardiogram
These three assessments may help to uncover hidden risk factors, including hypertrophic cardiomyopathy, cardiac arrhythmias and valve abnormalities, that could result in a sudden cardiac event. In a young athlete, these conditions rarely produce symptoms until intense, strenuous physical exertion results in a severe cardiac event.

It's also recommended that an automated external defibrillator is on site during school-sponsored sporting events and practices. Data shows that using an automated external defibrillator within ten minutes may save 80 percent of those suffering a cardiac arrest. Waiting for emergency medical staff to arrive dramatically reduces an athlete's chance of survival.

It's also important for athletes to always use the right sports safety equipment and adhere to the rules of the game to reduce collisions and trauma from an intense impact.

Sudden Death in Athletes in The News

In the spring of 2011, Michigan high school basketball star Wes Leonard collapsed on the court after making a game-winning shot. The medical examiner's report found that Leonard suffered a cardiac arrest due to dilated cardiomyopathy (an enlarged heart). According to his family, 16-year-old Leonard had no known previous heart condition.

More Tips for Sports Parents

Sources

Maron, Barry, et al. http://jama.ama-assn.org/content/276/3/199.full.pdf+html?sid=b306e364-7254-4f2e-a1f1-fa765035a4cb. Sudden Death in Young Competitive Athletes: Clinical, Demographic, and Pathological Profiles. JAMA. 1996;276(3):199-204.

Maron, Barry, et al."Clinical Profile and Spectrum of Commotio Cordis." JAMA. 002;287(9):1142-1146

Maron, Barry J. Hypertrophic Cardiomyopathy: A Systematic Review. JAMA. 2002;287(10):1308-1320.

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