Sudden cardiac arrest and death is a rare but tragic event for young athletes
A new report finds a steady decline in these fatalities among NCAA athletes over the past 20 years
Fatalities continue, however, and Black athletes, especially basketball players, appeared to be at highest risk
TUESDAY, Nov. 14, 2023 (HealthDay News) -- The sudden cardiac arrest experienced by Buffalo Bills' player Damar Hamlin in January thrust the health threat into the spotlight as never before.
Hamlin has since made a recovery from his attack, and a new report offers another bit of good news: Sudden cardiac deaths among National Collegiate Athletic Association (NCAA) athletes have dropped year-by-year over the past two decades.
These tragedies declined in frequency by 29% every five years between 2002 and 2022, according to research presented Monday at the annual meeting of the American Heart Association (AHA) in Philadelphia. The findings were published simultaneously in the AHA journal Circulation.
Study lead author Dr. Bradley Petek believes "the decline in overall rates of sudden cardiac death in the current study may be explained by improved survival rates from an initial sudden cardiac arrest event, thanks to more widespread education on the importance of CPR training, AED availability and emergency action plans."
It could also be due to "improvements in pre-participation cardiovascular screening," said Petek, who directs sports cardiology at Oregon Health & Science University in Portland, Ore.
Fatalities still occur, however. The study found that rates of sudden cardiac death remained highest among male athletes, Black athletes and basketball players.
Black players face nearly three times the odds of dying from sudden cardiac arrest as white players, the data showed.
And NCAA Division 1 male basketball players had the highest incidence of sudden cardiac death overall -- more than 1 per 2,000 over a four-year career, Petek's team found.
In the study, researchers looked at data from a variety of sources -- the National Center for Catastrophic Sports Injury Research database, the NCAA Resolutions List, the Parent Heart Watch database, insurance claims and media reports. That data was used to identify NCAA athlete deaths nationwide from July 2002 through June 2022.
Overall, 1,102 deaths were identified, 78% of which occurred in male athletes. A total of 143 of the fatalities were deemed to be sudden cardiac deaths, making it the leading medical cause of death.
Breaking those 143 cases down, 17% were thought to be related to defects in underlying heart structure and 13% were due to a thickened heart muscle (hypertrophic cardiomyopathy). Both of those conditions can trigger abnormal heart rhythms.
Just over 19% of cases showed no heart abnormalities upon autopsy, the researchers said, suggesting that aberrations in the heart's rhythms may have caused the attack.
"Commotio cordis — the condition that reportedly affected NFL player Damar Hamlin earlier this year — accounted for 2 deaths during the 20-year study period," the AHA noted in a news release.
More work needs to be done to understand -- and better prevent -- these on-field tragedies, Petek said.
“The incidence and causes of sudden cardiac death among young, competitive athletes impact prevention strategies yet remain incompletely understood,” he said in the AHA news release. “We have the opportunity to greatly improve outcomes through ongoing training and education of CPR, providing better access to defibrillators, and promoting the use and adherence to emergency action plans.”
Dr. Shelley Miyamoto is immediate past chair of the American Heart Association’s Council on Lifelong Congenital Heart Disease and Heart Health in the Young.
Reviewing the new findings, she said it's surprising that so many cases of sudden cardiac death give little clues as to their cause.
“That is particularly troublesome to everyone involved," she said. "If we can't understand the cause of the sudden cardiac death, it is going to be difficult for people to accept and understand how to prevent it in the future. Genetic testing in those individuals who suffer sudden cardiac death from an undetermined cause is something we need to pursue aggressively. Genetic testing may potentially provide some answers for why an athlete died suddenly, and it may also provide some insight into whether other family members could be at risk.”
Find out more about sudden cardiac death in young athletes at the American College of Cardiology.
SOURCE: American Heart Association, news release, Nov. 13, 2023
While on-field tragedies still occur, the overall rate of sudden cardiac deaths among NCAA players has fallen steadily over the past two decades