Sudden cardiac death is most common in contact sports like football, basketball and soccer because of the exertion required. A cardiac concussion — a smack to the chest with a ball, helmet or another player — can lead to chest trauma causing the heart to go out of rhythm.
Isaiah and Oen’s deaths have brought more attention to sudden cardiac death, which claims about 500 young lives every year in the United States, Lipshultz says.
Lipshultz cites countries like Italy, which reduced sudden cardiac death by 89 percent among athletes ages 14 to 35 in a 20-year period after implementing a mandatory sports screening program in 1982. In Japan, screenings of the heart are mandatory for all students entering school, regardless if they are athletes.
“In Italy, they have reduced the number of sudden cardiac deaths by identifying and treating appropriately,” Lipshultz says. “In the U.S. there’s a feeling there’s a cost and it’s not cost-effective. But if you are a family who has lost a child, statistics don’t matter. In the U.S. we have the ability to identify more children who are at risk for sudden death but we don’t implement it.”
There is a movement to address the problem locally. Earlier this year, Miami Children’s Hospital began offering free EKG screenings to middle and high school sports participants. The hospital, noting that every three days in the U.S. a student athlete dies of sudden cardiac death (SCD) and experiences no advance signs or symptoms, has become an advocate for early detection.
“Usually, checkups are done by pediatrician physicians and nothing was picked up,” says Dr. Danyal Khan, pediatric interventional cardiologist at Miami Children’s Hospital. “We are aiming at young athletes, people in school or college, or anyone who wants to be screened, they can come over to Miami Children’s Hospital or our urgent care centers and have a free EKG. It doesn’t matter if they have insurance because we are not checking any of that.”
So far the hospital screens about 25 people a week with EKGs, a simple, pain-free test that uses electrodes placed at strategic locations on the body to measure the electrical impulses of the heart.
“This does not pick up each and every cause out there, but this is the simplest and quickest test that should pick up half the causes of sudden cardiac death,” Khan says. Also, if there is a history of premature death from heart disease in a player’s family, meaning someone younger than 50 in a person’s family died as a result of heart disease, more extensive tests, like electrocardiograms to see the internal structure of the heart, may be ordered.
If an abnormality is detected, treatment options vary, Khan says. “They can be put on medicines, sometimes they need a defibrillator implanted inside their bodies. If the heart is misbehaving, we can shock the heart back to rhythm,” he says.
Some factors weighing against routine testing is the cost, especially follow-up costs, the potential for false-positive readings, and the need for trained people to properly read and interpret tests. For these reasons, the American Heart Association does not recommend routine EKG screenings of student athletes but, rather, only a medical history and physical exam.