What common heart conditions should young athletes be aware of?

Age is important. People under the age of 35 tend to be perceived as problematic by a different group of people than those over 35.

In younger people, congenital heart disease, or heart disease present at birth, often causes SCA.

Hypertrophic cardiomyopathy (HCM) is the most commonly identified congenital heart defect among elite athletes with SCA, especially those younger than 35 years. The second most common cause is an abnormality at the aortic root of the coronary artery. It is also a congenital disorder in which one (or more) of the coronary arteries that supply blood to the heart begin with an abnormally positioned aortic root. It is called anomalous origin of the coronary arteries. Arrhythmogenic right ventricular cardiomyopathy (ARVC), another genetic disease that causes abnormalities in heart structure and predisposes to dangerous heart rhythms, has been identified as a cause of SCA among young elite athletes.

According to reports, Bronny James’ cardiac arrest was caused by a congenital heart defect. Although the specific defect has not been disclosed, doctors are confident it is treatable and the prognosis is good enough that he will be allowed to play competitive sports again.

These symptoms are not common to all athletes. The prevalence of HCM is as high as 1 in 200 in the general population, but the estimated prevalence in athletes is much lower (approximately 1 in 5,000 or more). On the other hand, the prevalence of ARVC-like conditions varies widely depending on geographic location. It is relatively rare in the United States, but tends to be more common in countries such as Italy and Denmark.

It is unclear why such mutations exist, but there may be factors related to differences in genetic structure or screening processes.

What about non-congenital heart disease?

Damar Hamlin had a structurally normal heart. He experienced a phenomenon known as comotio cordis, which is one of the most common mechanisms of sudden cardiac arrest that occurs in young people during contact sports. Cordis disease is caused by blunt trauma to the chest while the heart is recharging for the next heartbeat. During this vulnerable period, the trauma causes the heart’s rhythm to become so unstable that it no longer has effective compression on the heart and blood circulation stops. In Hamlin’s case, there was blunt force trauma to his chest while his heart was recharging, which triggered the thunderstorm. Fortunately, with prompt recognition and treatment (cardiopulmonary resuscitation and external shock from a defibrillator), this type of dangerous arrhythmia can be stopped, and the prognosis for those affected is good.

Luis Tejada was 41 years old. According to news reports, he likely suffered a heart attack due to a blockage or narrowing of a coronary artery. Unfortunately, people occasionally experience heart attacks of various kinds at a young age.

Over the age of 35, this etiology of sudden cardiac arrest becomes more common, as narrowing of the heart’s arteries (so-called atherosclerosis) is more likely to occur. This may not be a problem when a person is doing normal activities, but when a person is participating in strenuous activity, the oxygen supply to the heart suddenly becomes insufficient. Muscles are essentially overworked. The lack of oxygen to cells within the heart then causes this electrical disruption, causing the heart to fibrillate and stop blood from circulating.

So, is it dangerous for professional athletes to continue competing past the age of 35?

It’s not necessarily dangerous. Tejada was unlucky. Because he’s 41 years old, and even more so, it’s rare for him to have a heart attack at such a young age, 35. We know it happens, and cardiologists see it, but it’s not that common. It is difficult to quantify because it relies on information provided by the athlete about what symptoms are likely. Additionally, many athletes, especially elite-level athletes, may not be aware or aware of symptoms that may be related to underlying heart disease, or may only be aware or aware of them. there is. Please deal with it. For example, shortness of breath or chest discomfort during activity, or some change in performance may be overlooked as “normal” or minimized to avoid potential perceptions of weakness or lack of skill in the sport. This could be an important sign that you are about to get lost.

What sport causes the most cardiac arrests?

It depends on the underlying etiology. Cordis disease is most likely to occur in young children who may be exposed to blunt chest trauma, such as playing baseball or hockey. This known risk is at least partially accounted for in the regulations regarding padding as part of uniforms for such sports. But in general, there are less common reasons why athletes go into sudden cardiac arrest. Several studies have shown that the sports with the highest rates of cardiac arrest in athletes are men’s basketball (especially at the NCAA level) and football.

How is sudden cardiac arrest different from a heart attack?

When we talk about sudden cardiac arrest, we are actually talking about an electrical phenomenon. Electricity is what moves the heart. And when it is organized, the heart beats effectively. However, when the heart becomes confused or confused, as in sudden cardiac arrest, the heart suddenly stops pumping blood, as if it had stopped beating, even if there is nothing structurally wrong.

A heart attack refers, in particular, to a blockage of the arteries of the heart, leading to a so-called myocardial infarction. What this means is that some tissue in the heart muscle is dying because its blood flow and oxygen supply are compromised. That’s what the infarcted part means. This process does not necessarily lead to sudden cardiac arrest.

So sudden cardiac arrest can occur when there’s nothing wrong with the arteries, and there’s nothing necessarily wrong with the structure of the heart, but the electrical activation is disrupted. In the case of a heart attack, electricity works normally except for the parts of the heart where the heart cells don’t get enough blood and die.

Should young athletes diagnosed with congenital heart disease avoid sports?

That’s a great question.

For example, by the time you get to the NCAA level of competition, protocols exist to screen for more common types of deficiencies. And in many cases, those athletes are prevented from competing at that level. So does that mean we should avoid all sports? necessarily. It really depends on the severity of what they have. Patients whose disease has progressed to the point where they require an implantable cardioverter defibrillator (ICD) usually have the device implanted because their condition is severe enough to require treatment for possible recurrence. These people are usually discouraged from playing competitive sports. However, having such conditions, including ICD, does not necessarily mean that you cannot participate in recreational sports or that you are not active. They probably just avoid competitive sports.

Are there any early signs to look out for before this happens?

Symptoms may also occur. As mentioned earlier, there are probably more instances than we realize where subtle performance-limiting symptoms are present but ignored or downplayed. A colleague of mine had a strange indigestion-like sensation once, which subsided after resting. He had a similar experience a week later, was seen by a cardiologist, and within a week was diagnosed with severe coronary artery disease and underwent surgery. He had acute symptoms but no chronic symptoms.

Common symptoms that suggest an underlying heart problem include shortness of breath or chest discomfort, especially with exertion, intermittent or persistent decreased level of performance or functional ability, You may experience palpitations, dizziness, and lightheadedness.