Sudden cardiac arrest (SCA) is the most common cause of sudden death in athletes. It is a condition in which the heart experiences a heart rhythm abnormality and suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. It is a true medical emergency.
Sudden cardiac arrest is not the same as a heart attack – although, according to Dr. Thomas Callahan, a staff physician at Cleveland Clinic, having had a heart attack or multiple heart attacks can predispose you to SCA. (He points out that about 30 percent of deaths in young athletes is due to SCA.) Other risk factors for SCA include a family history of cardiac arrest, certain genetic diseases that affect the heart, coronary artery disease (CAD), cardiac sarcoid, and abnormal origins of the coronary arteries. Coronary artery disease, once a disease of middle age, is now being seen in teens and young adults due to poor lifestyle choices and increased rates of obesity.
Former Miss Ohio Lindsay Davis has been instrumental is raising awareness about the risk of sudden cardiac arrest in young athletes. She herself was an avid ballet dancer for many years, dancing seven days a week, and she did not initially heed the warning signs (like dizziness) that she was experiencing while dancing. When she finally went to the emergency room after collapsing, she was diagnosed with hypertrophic cardiomyopathy, a heart condition that put her at increased risk of SCA. Now, she’s on a mission to educate young athletes, coaches and the general public about how to detect and treat this life-threatening heart disorder. Legislation, known as “Lindsay’s Law,” was recently passed in Ohio calling for coaches to undergo training to recognize and know how to handle symptoms of sudden cardiac arrest.
Every hour at least 38 people suffer from a cardiac arrest outside of a hospital in the U.S., adding up to almost 400,000 people annually. It can happen to anyone, even young athletes, at any time, but awareness of the signs and symptoms and prompt action can save lives. According to the Sudden Cardiac Arrest Foundation the number of people who die each year from SCA is roughly equivalent to the number who die from Alzheimer’s disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer, and suicides combined.
Four out of 10 victims of SCA can be saved through early intervention with cardiopulmonary resuscitation (CPR), defibrillation, advanced cardiac life support, and mild therapeutic hypothermia. You can save someone if you know CPR or can use automated external defibrillators (AEDs) before EMS arrives.
When asked about screening for SCA, Dr. Callahan suggestedthat "there’s no single perfect test so cardiac screening does not capture everyone – education is key – knowing the warning signs (so you get screened) and also having people trained in CPR should SCA occur. For those identified as high risk for SCA, we then implant a defibrillator which monitors the heart rhythm and rescues the person if they have a cardiac event.”
Signs and symptoms to look for include:
- Shortness of breath
- Chest pain, discomfort, pressure
- A feeling of symptoms out of proportion to the athletic effort
- Passing out during exertion
Dr. Callahan also noted the importance of knowing if you have a family history of SCA.
Lindsay’s Law, meanwhile, is an awareness bill modeled after the concussion legislation that’s been passed in 50 states. During the interview Lindsay shared that its aim is “to educate coaches, parents, and teachers of the signs that may indicate an underlying (and not yet diagnosed) heart condition. It also requires that if a coach sees a student or athlete exhibiting any of the noted signs or symptoms, they are then pulled from play (immediately) to be screened for any heart abnormalities before returning to play.” It’s personal for Lindsay because she feels she was given a second chance at life.
I asked Lindsay how she’s doing now that she’s been diagnosed and treated with an implanted defibrillator. “I am lucky to have the Boston Scientific defibrillator implanted. I feel like I have a mini-emergency room in my chest at all times and I feel safe and able to live a completely normal life."
Towards the end of the interview I asked Dr. Callahan about the chances of SCA occurring in an athlete at the Rio Olympics and whether there’s enough SCA awareness among athletes participating at that level.
“Cardiologists like myself,” he replied, "and governing bodies at the American Heart Association recommend that any young individual participating in competitive sports should be screened. That screening should include a history and physical exam. There are ongoing debates about use of EKGs and echo-cardiograms since they’re not perfect.”
Clearly, most athletes currently participating in the Rio Olympics should have had screening for any risk factors.
At the close of the interview Lindsay shared that you can learn more about SCA at SICD.com, sponsored by Boston Scientific. Dr. Callahan said that knowing CPR plus having an AED on site are crucial to saving the life of someone who experiences SCA. A study released in the Journal of the American College of Cardiology suggests that there is currently only a one in five chance that an AED will be nearby when someone experiences a cardiac arrest.
Lindsay hopes that Lindsay’s Law becomes a national mandate similar to recent legislation requiring all high school graduates to know CPR in order to graduate. It’s clear that Lindsay’s Law can help to save lives.
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Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”