Team sports can bring local communities and countries together and give us the opportunity to put aside our differences as we root for our favored teams. For those of us who are parents of an athlete, we take pride when our child’s team scores the winning touchdown or when they display acts of sportsmanship to their teammates and the opposing team. When a young athlete sustains a significant injury or goes down the way Damar Hamlin did on January 2, we take a step back and reflect on how lucky we are and for a brief moment remind ourselves how fragile life is.
Many school-aged children — and adults — view professional athletes as indestructible and so when sudden cardiac arrest occurs in an athlete, it shakes our confidence and, naturally, scares us to our core. As pediatric physicians, parents often ask our advice on how to explain publicized traumatic events to our children. Even if the game was well past our children’s bedtime, they will likely hear about it the following school day, at the family dinner table or see a tweet/post on social media.
Dr. Shaun Mohan
I will admit, that at least daily, I have looked at the news on CNN or NPR for the latest updates on Hamlin’s recovery and become optimistic as his family and friends convey their gratitude for all the support and well wishes from his fans and the public. Sudden cardiac arrest (SCA) in athletes is unfortunately not a new phenomenon. It is the leading cause of death in young athletes and up to two-thirds of SCA deaths occur without any prior knowledge/indications of heart disease. This is not the same as a “heart attack” that we see in middle-aged and older adults from a blocked or clogged vessel in the heart muscle. For most SCA in the young during athletics, it is usually from a dangerous cardiac electrical rhythm that gets triggered leading to the heart not having an organized rhythm and then stopping pumping blood to the body.
My parents still recall when Hank Gathers had a sudden cardiac arrest during the NCAA game as the star forward for Loyola Marymount in 1989. Unfortunately, Gathers was not as fortunate as Hamlin to play in an era where CPR training and automatic external defibrillators (AED) became an expectation at every NCAA game. Gathers was known to have a predisposing cardiac condition called hypertrophic cardiomyopathy, an abnormal growth of cardiac muscle that increases the risk of going into dangerous fast cardiac rhythms to can lead to sudden cardiac arrest. At present time, we believe that Hamlin had no predisposing cardiac condition that led to his arrest and I am sure we will learn more as his medical team and Hamlin himself are willing to disclose to the public.
As human beings, we tend to focus on the “why” when events like these occur because they shake our confidence as parents, health professionals, and spectators. The question that should be asked is “what next?” As a pediatric cardiologist and electrophysiologist, I see young patients on a regular basis to evaluate for concern for a cardiac condition, and I have diagnosed a number of patients/families who have a known cardiac disease that can lead to early sudden cardiac death during sports and normal activities.
At the present time in our commonwealth, high schools require cardiopulmonary resuscitation (CPR) training in the health education curriculum, however, there is no requirement to have automatic external defibrillators on the premises of public high schools. Our hope is to change this in all public schools across the commonwealth through collaboration with national SCA advocacy groups/organizations such as Project ADAM and the American Heart Association.
At this juncture, I would encourage all public school officials to ensure that any supervised athletic event has appropriately trained CPR personnel and advocate for an AED at all events. If our teenagers can be taught CPR, then certainly any adult can be trained if interested. Please refer to https://www.redcross.org/take-a-class/cpr/cpr-training/cpr-certification to look for local CPR training classes.
Dr. Shaun Mohan, M.D., is pediatric cardiologist and electrophysiologist at the Kentucky Children’s Hospital Congenital Heart Clinic.
