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Heart defects in young athletes rare but deadly
A recent study by the University of Washington’s Department of Family Medicine found that one in every 44,000 NCAA collegiate athletes will die from sudden cardiac death (SCD).
While the study focused on college athletes and discovered that the true number of deaths in U.S. athletes from SCD is unknown, it was clear that even though SCD is rare, it can and does happen.
The study, titled “Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes,” led by Dr. Kimberly Harmon of the University of Washington, revealed that tracking the number of athletes who die from the condition is difficult, but that it does happen more often than people may think.
Preventing and preparing for such events can be difficult, but many are finding ways to bring awareness to the issue in the hope that it can be avoided in the future.
All high school athletes in Washington are required by the Washington Interscholastic Activities Association to have a sports physical every two years. But, as Mercer Island High School Athletic Director Craig Olson said, Mercer Island schools recommends students have one done every year.
“A lot can change with teenagers in two years,” said Olson. To play a sport for MIHS, each athlete must have a physical, reviewed by a doctor, signed paperwork agreeing to the athletic code, an emergency medical form and an acknowledgment of information on concussions. MIHS also requires each player to read and sign a safety guidelines and risk letter for each sport.
The physical questionnaire features a variety of yes/no questions, including several which help a doctor determine if a young athlete is potentially at risk for heart trouble. Questions such as have you ever passed out during or after exercise, have you ever been dizzy during or after exercise and has anyone under 50 years old in your family died of heart problems, help the physician decide if that area needs further scrutiny.
Dr. Hal Quinn, a physician with Mercer Island Pediatrics, who also serves as a doctor on the sideline during Mercer Island High School football games, said the forms should be completed by the parent and student, together. He said sometimes he’ll see a form that the parent has done themselves, or that just a student fills out.
“It’s important for both the parent and the child to review and complete the form together, prior to the visit,” said Quinn. Doing so helps the doctor and family get a full idea of what is going on and any potential risks. Based on that information, Quinn said, if there is an area of concern, the next step is typically listening to the heart and possibly taking a closer look.
“Certainly, there are things that we won’t be able to pick up,” he said. “Maybe not even in the family history.” In the rare occurrence when a child athlete does experience chest pain with exercise or has other symptoms, an electrocardiograph (ECG) is done.
While there hasn’t been a ton of research done on the number of high school athletes who die from SCD, one thing doctors know is that though it gets attention nationally when it happens, it is very rare. SCD affects a greater number of people over the age of 40, but youth can be at risk. According to the American Heart Association, there are an estimated 1,900 to 14,200 cases of out-of-hospital sudden cardiac arrest in children across the United States every year.
“It’s tragic and awful,” said Quinn of cases when a child dies from SCD. “Some are probably preventable, but in some cases you just can’t tell.”
Sometimes there is simply no way to know and no way to prevent SCD from happening, but there are organizations offering screenings and educating people, hoping to avoid such a tragedy.
The Nick of Time Foundation is one such organization. Nick Varrenti, a 16-year-old football player who attended Jackson High School in Mill Creek before moving to the East Coast, died of sudden cardiac arrest in 2004. His family created the foundation in his name, working to make sure schools have automated external defibrillators (AED), as well as offering heart screenings around the state. One such screening will take place on June 1 at Garfield High School for anyone ages 14 through 24.
AEDs are another way people are working to prevent a cardiac event from turning into a worst-case scenario situation. The Mercer Island School District has nine AEDs on its various school campuses in case of an emergency, including one at the football field.
Joy Dunne, the nurse at the high school and CPR/AED coordinator for the district, said each was paid for through donations to the district, including money from the Mercer Island Rotary Club, the PTSAs and a parent who donated two.
“Each AED runs about $3,000, so it was a big donation,” said Dunne. There are also 16 AEDs in city buildings around the Island, including an AED in each Mercer Island police patrol car.
Even with AEDs around the community, learning the risks and how to be heart healthy is important. On May 21 at Marymoor Park, the Nick of Time organization will team up with Ironheart Racing for the Nick of Time Community Festival. The event will feature the Ironheart Classic, a four or eight-mile run, while raising awareness and promoting heart-healthy choices. The money raised from the race will benefit the foundation.
“We are very happy to be the recipients of the race and continue to raise awareness about sudden cardiac arrest,” said Darla Varrenti, the executive director of Nick of Time.
In large part because of increased attention, the question has been asked if it’s time for a greater number of screenings. Quinn said requiring screenings for all high school athletes could be just as problematic.
“There are countries that do require screenings, like an ECG, but they have a different health care system,” said Quinn. Italy has required such a screening since 1982 for athletes in competitive sports, and Israel requires a heart screening for anyone in organized activities. Other countries, like Denmark, don’t even require a physical review of any kind before participation in sports.
“If we did that (required screenings), there are two big challenges. The first is: that is a lot of manpower — even if each screening is only 15 minutes, the cost would be substantial,” said Quinn. The second issue, Quinn said, would be an increased number of false positives.
“When you screen for something rare, you put more stress on the system and will get more false positives,” he said. For example, Quinn said, it’s similar to why his office doesn’t screen everyone for tuberculosis. There would be more false positives than actual cases, which would lead to increased numbers in need of further testing.
“No one wants to miss anything, but it’s not so easy to screen for,” said Quinn.
As more research is done, and better numbers on occurrences become available, doctors and patients will be able to gain a better idea of what can be done, and whether or not that may include a greater number of screenings for youth.
AEDs on the Island
There are several automated external defibrillators located on Mercer Island.
The Mercer Island School District has nine AEDs in school buildings, including three at MIHS, two at IMS, one in the administration building and one at each of the district’s elementaries.
There are also 16 AEDs in city buildings on the Island, including one each at Luther Burbank Park and Groveland Beach. The Mercer Island Beach Club, Mercerwood Shore Club and Stroum Jewish Community Center also have AEDs.
To learn more about SCD and the foundations raising awareness, visit:
• www.heart.org (American Heart Association)