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Sudden Cardiac Arrest (SCA)

What is sudden cardiac arrest?

SCA is among the leading killers of Americans, striking an estimated 382,800 people in the US each year. SCA is an abrupt loss of heart function caused primarily by the rapid and/or chaotic electrical activity of the heart known as ventricular tachycardia (VT) or ventricular fibrillation (VF). During SCA, the heart fails to pump blood to the vital organs. Signs of SCA include unconsciousness and irregular or no breathing. SCA renders a person clinically dead within minutes, unless treated immediately with defibrillation or with bystander CPR followed by defibrillation. For every minute that elapses after SCA, the chances of survival diminish 10 percent. SCA is NOT a heart attack (myocardial infarction), which is caused by a blocked vessel leading to loss of blood supply to a portion of the heart muscle. However, sudden cardiac arrest often occurs secondary to a heart attack. The media often confuses these very different terms when reporting.

Sudden cardiac arrest in young athletes.

The causes of SCA in children and adolescents are varied and often include undiagnosed heart conditions that result from abnormal heart structure or function, primarily structural or electrical abnormalities of the heart. Outside factors such as a sudden blow to the chest or drug use can also cause SCA. The most common cause of SCA in the young athlete is a condition called hypertrophic cardiomyopathy (HCM).  It is well known that HCM will develop in 1 out of every 500 children.  While this condition is not always fatal, it greatly increases the risk of SCA and death within the young athlete population. In 2014 there were roughly 8.4 million student athletes in the United States.  That means that about 16,800 student athletes are playing with a very real increased risk of SCA and death from HCM alone.  Other electrical conduction and structural abnormalities of the heart combine to put the number of student athletes at risk of SCA in the 10’s of thousands.  In the United States, a young, seemingly healthy student athlete dies suddenly every two to three days. There is no national registry to track death from SCA in young athletes, emerging research proves that SCA in the young athlete population is NOT RARE. The average age when sudden cardiac death occurs in young athletes is 17.5 years. The risk of SCA is three times greater in competitive athletes. More than two-thirds of young athletes who die suddenly are basketball and football players (67%). College male basketball players are disproportionately affected by SCA (1 in almost 7,000). Current standard sports physicals CAN NOT detect nearly any of the conditions that cause SCA in an otherwise healthy student athlete.  The current sports physicals rely solely on a medical history questionnaire and brief physical exam.  None of the top causes of SCA can be detected this system. Protecting our student athletes is imperative!  We can accomplish a much higher level of protection from SCA by adding a few cardiac specific exams to the sports physical. An electrocardiogram (EKG) is a tracing of your hearts electrical system.  This simple and painless test takes only a few minutes to perform and is much more likely to detect an underlying heart condition.  An echocardiogram or ultrasound of the heart may also be useful in detecting unknown heart conditions.  This test is also painless and thoroughly looks at the hearts structure and function. Italy is the only country in the world to institute this higher level cardiac sports physical mandatory for every student athlete.  There has been a decrease of death by SCA in young athletes of 89%! This is the most powerful and only statistic we need to remember when deciding how we should screen our youth for heart conditions.

How you can help prevent sudden cardiac arrest and save the lives of sudden

cardiac arrest victims.

Recognizing the symptoms of possible SCA is the first crucial step. o Fainting or seizures during physical activity or from emotional excitement. This is the number one warning sign of SCA. Fainting is never normal and should be investigated thoroughly by a medical specialist. o Dizziness or feeling light-headed during exercise.  This could be an ominous sign of weakened underlying heart function. o Chest pains or pressure at rest or during exertion.  Pains in the chest area can be difficult to evaluate by verbal explanation, even for experienced medical professionals.  Any chest pains warrant thorough testing of the heart to look for underlying heart conditions. o Palpitations, also referred to as fluttering of the heart or skipped beats. These could indicate electrical abnormalities of the hearts conduction system. o Inappropriate levels of fatigue or just tiring more easily than teammates or friends.  This could indicate weakened heart function. o Inappropriate shortness of breath with exercise.  We all know shortness of breath happens when you push yourself in exercise.  If the level of shortness of breath doesn’t fit the level of exercise, it could point to a heart condition. Recognizing when someone is experiencing SCA is crucial as well. You should always call 911 if you see someone collapse. o SCA is time critical! Waiting for help to arrive will decrease the chances of survival. If chest compressions are not provided to SCA victims within a few minutes, they will likely die. o Chest compressions keep oxygen in the blood circulating throughout the body. o Using an AED to shock the heart back into rhythm can double the chance of survival.
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Villanova Basketball Boach Jay Wright on Sudden Cardiac Arrest - Simon's Fund