When it comes to keeping athletes safe, most people think about such injuries as concussions or broken bones. But heart health is just as important, according to Dr. Ray Stewart, assistant professor of sports medicine with the College of Community Health Sciences.
In a recent Grand Rounds lecture to CCHS faculty, residents and medical students, Stewart talked about the dangers of sudden cardiac arrest, or SCA, in young athletes and the importance of cardiovascular screening to help lower the risks. Stewart also cares for patients as a sports medicine physician at University Medical Center, which is operated by the College.
Sudden cardiac arrest happens when the heart suddenly stops beating. It often occurs without warning and can be fatal if not treated immediately.
Stewart said SCA is the leading medical cause of death among young athletes with most cases occurring during high school sports; the risk is highest in male basketball players, as the sport involves quick, intense bursts of activity that can strain the heart and expose hidden conditions.
“Nationwide data shows the rate of SCA in student athletes is about 1 in 67,000 deaths per year,” said Stewart. “Because most of these cases happen at the high school level, there’s a greater need for better screening and emergency planning at those ages.”
Most athletic screenings typically include a pre-participation physical examination (PPE) about personal and family health history. But Stewart noted that PPEs primarily identify athletes with symptoms or a family history of cardiovascular disorders but can miss cases of silent heart, conditions, such as thickened heart muscle, scarred heart tissue or electrical problems in the heart, which are leading causes of SCA in athletes.
He recommends adding an electrocardiogram, or ECG, to the screening process. An ECG is a quick, noninvasive test that records the electrical activity of the heart. The test can help detect abnormal rhythms or signs of structural heart problems that could go unnoticed.
Stewart mentioned that the International Criteria for ECG Interpretation in Athletes, endorsed by major sporting and cardiology organizations worldwide, can help physicians detect the difference between normal athletic heart changes and warning signs of cardiovascular conditions.
“Many athletes report symptoms such as chest pain or fatigue that can be unrelated to cardiovascular disease, resulting in unnecessary secondary evaluations, increased health care costs and potential restriction from sports,” said Stewart.
He also recommended that schools and sports programs have emergency action plans in place, such as CPR training, and access to automated external defibrillators, or AEDs, at all athletic events. “Secondary prevention is critical,” Stewart said.