Could your young athlete be at risk of sudden cardiac arrest?

Playing sports comes with a lot of perks. Whether it's getting exercise, participating on a team or having fun, athletes benefit from their time on the field, track or court in plenty of ways.

But athletes also need to be aware of the risks of playing sports. For instance, football players should know the risks of concussions and take measures to prevent them, like wearing a helmet that fits properly.

Because all athletes put their hearts to work during physical activity, they should also be aware of a condition called sudden cardiac arrest (SCA).

"Sudden cardiac arrest is when the heart suddenly and unexpectedly stops beating, often triggered by an abnormal fast heart rhythm. While this condition is rare, it's also one of the top causes of death in young athletes. What's more, people who suffer from SCA often appear otherwise healthy," says Jason Bradley, MD, director of the Sports Cardiology Program at Lankenau Heart Institute, part of Main Line Health.

Here's what young athletes should know about sudden cardiac arrest, their heart health and engaging in sports safely.

How can playing sports trigger sudden cardiac arrest?

Whether you're swimming laps, skating on the ice or kicking a soccer ball, your muscles are being put to work when you play sports. Because of this, they need extra oxygen.

This is where your heart comes in. To deliver extra oxygen to your muscles, your heart pumps harder, which is why your heart rate increases during exercise.

Your heart working hard is a good thing. Exercising your heart muscle regularly makes it stronger and better at pumping blood throughout your body. This improves your heart health and lowers your risk of heart disease.

"While the majority of athletes tolerate these changes with no issues, in athletes whose hearts are not normal to begin with, this extra stress on their heart can cause problems," says Dr. Bradley. "Even in athletes with normal hearts, physical activity can impact the heart's electrical system at the wrong time causing sudden cardiac arrest."

Athletes who have a higher risk of sudden cardiac arrest

The majority of young athletes can engage in sports with no heart problems. But because sudden cardiac arrest is a serious and deadly condition, it's important to be aware of your own risk of SCA.

In athletes under age 35, the most common cause of SCA is a genetic heart disease, such as:

• A heart muscle disorder, such as hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy.
• A heart rhythm disorder, such as Wolff-Parkinson-White syndrome, Long QT syndrome or catecholaminergic polymorphic ventricular tachycardia.

You may also have an increased risk of SCA if you:

• Were born with an abnormal heart artery
• Have a heart infection
• Have Marfan syndrome (a disorder that impacts the proteins that make healthy connective tissue, such as those that support your heart)
• Have coronary artery disease, which is the leading cause of SCA among people older than 35

Monitoring your heart health and risk of SCA

Many of the causes of sudden cardiac arrest go undetected until sudden cardiac arrest occurs. However, there can be warning signs during exercise, including:

• Dizziness
• Chest pain
• Shortness of breath
• Fainting
• Seizures

If you have any of these symptoms while exercising, it's important to talk to your healthcare provider. You should also tell them if you have had a sudden or unexplained death in your family, which may have been related to a heart problem.

Depending on your symptoms and family history, your provider may do further testing, such as an electrocardiogram (ECG or EKG) or echocardiogram (echo). These tests look at how well your heart functions, which can help determine if and how you can engage in sports safely.

They may also refer you to a program like Lankenau Heart Institute's Sports Cardiology program.

"This program is driven by the full understanding of the importance of timely evaluation of athletes so they can return to their sport as quickly—and as safely— as possible," says Dr. Bradely. "We're able to see athletes within 24-48 hours."

The Sports Cardiology program offers:

• Evaluation of athletes for cardiac symptoms both on and off the field, abnormal physical exam findings, abnormal cardiac testing, and "return to play" assessments.
• A full range of cardiac testing will be available as needed including echocardiography, stress testing, Holter monitoring, and cardiac MRI.
• Advanced workup, as needed in select patients, to be performed in conjunction with Lankenau Heart Institute's array of advanced imaging modalities, our Genetics and Risk Assessment Program and our Electrophysiology colleagues.

Can I still play sports if I have a higher risk of sudden cardiac arrest?

If you have a higher risk of SCA, you don't have to immediately throw in the towel when it comes to playing sports. While in the past, athletes with heart conditions were told to avoid sports, but this is not always the case.

In the right circumstances, athletes with a risk of SCA can play sports with low risk. Your healthcare provider can help determine how intense your physical activity should be and how closely you should be monitored. They'll also give you recommendations, like staying hydrated and keeping an eye on your electrolytes.

All sports teams should also have an emergency response plan in place should an athlete experience SCA, as every minute will be crucial in saving their life.

Exercise has many benefits, including for your heart health. As you take care of your body in other ways—like stretching, eating healthy and resting—make sure you stay on top of your heart health and know your risk of sudden cardiac arrest so you can play your favorite sport safely.

Next steps:

Make an appointment with Jason Bradley, MD
Learn more about cardiovascular care at Main Line Health
Learn about essential cardiac tests