For Young Athletes, a Key Save

New Guidelines Aim to Prevent Deaths of School, College Players From Sudden Cardiac Arrest

The last thing you might expect to see at a school sporting event is a student having a fatal heart attack. But sudden cardiac arrest accounts for possibly hundreds of such deaths a year among young competitive athletes in the United States, making it a leading cause of death for this population, according to some experts.

In an effort to reduce this toll, a task force convened by the National Athletic Trainers' Association issued guidelines last week to help high school and college athletic programs respond faster to sudden cardiac arrest, or SCA.

SCA occurs when an electrical malfunction in the heart causes it to contract rapidly and erratically so that it stops pumping blood. Though victims are often later found to have underlying structural heart abnormalities that increase the risk of such malfunctions, for most, SCA is the first sign that something is amiss. (One of those abnormalities, hypertrophic cardiomyopathy -- a thickening of the heart muscle that makes it harder for the heart to pump -- affects one in 500 people, according to the American Heart Association, and isn't typically discovered in the physicals that most students take before joining athletic teams.)

Strenuous physical activity is thought to trigger SCA, 90 percent of whose victims are male, according to physician Jonathan Drezner, associate director of the sports medicine program at the University of Washington in Seattle and lead author of the task force's consensus statement.

SCA can be halted by speedy use of a defibrillator, which delivers an electric shock that can correct the abnormal heart rhythm. But the window for use is small -- ideally, within five minutes after collapse -- and too often help comes too late or not at all. In the absence of a defibrillator, cardiopulmonary resuscitation (CPR) may improve chances of survival, by helping circulate some blood to the lungs and brain. But it won't correct the arrythmia.

"Survival in young athletes with cardiac arrest has been very poor for many years, around 10 percent," Drezner said. "Our goal is to help high school and college athletic programs prepare for and respond to cardiac emergencies."

The task force issued its statement, which emphasizes comprehensive emergency planning, in the April edition of Heart Rhythm, the journal of the Heart Rhythm Society. Among the top recommendations for schools:

· Decide who's going to do what -- including who's going to communicate with whom -- in an emergency, and practice your response plan.

· Train key people in CPR and the use of automated external defibrillators, or AEDs.