Safety Advocates Focus on Hidden Threats to Young Athletes

But the Washington group knew something most do not: the No. 1 killer of young athletes is sudden cardiac arrest, typically brought on by a pre-existing, detectable condition that could have been treated. Another substantial yet hidden lethal threat is heat stroke, a condition considered completely preventable. Concussions are receiving attention nationwide, but death from a blow to the head is exceedingly rare. In contrast, a young athlete dies from a cardiac incident once every three days in the United States, researchers say. In hot months like August, heat stroke often causes the death of a young athlete every other day on average. Concussion victims almost always get a second chance, said Laura Friend, an attendee at the Washington summit whose 12-year-old daughter, Sarah, died of sudden cardiac arrest while swimming at a Texas community pool in 2004. When your heart fails from something that could have been treated ? which happens all the time ? you don?ft have another chance. As someone told me, sudden cardiac arrest is not rare; surviving it is.?h Heat stroke, also known as exertional heat illness, has been a focus of sports safety advocates because of simple, common-sense preventive measures, like introducing gradual levels of exercise at the beginning of a sports season in hot temperatures. ??gWhen my son died, people treated it as a freak thing,?h said Rhonda Fincher, whose 13-year-old son, Kendrick, died in 1995 from heat stroke sustained during a season-opening football practice in northwestern Arkansas. ?gThe ignorance was unacceptable because, unfortunately, it is not infrequent. And we should all know that. ?gNo healthy child should be sent off to a routine practice and die from it.eaders of youth sports acknowledge that concussions have long been overlooked and that the injury deserves a period of heightened awareness, especially because of the potential for long-term consequences. But as the focus of the February conference organized by the National Athletic Trainers?f Association suggests, there is a mounting worry that more hazardous health concerns are being disregarded because of the intense emphasis on brain injuries. A sudden heart-related death is ?gso incredibly tragic and stunning that people aren?ft comfortable putting it into the everyday conversation,?h said Dr. Jonathan Drezner, the president of the American Medical Society for Sports Medicine. ?gI do wish, to some extent, it was something people talked more about,?h Drezner added, ?gbecause we are getting to a place where we could prevent many of these deaths.?h One factor that may be inhibiting the conversation is a widespread disagreement about the best course of action to reduce deaths from sudden cardiac arrest. The debate hinges on suitable precautionary measures for young athletes. The physical examination that virtually every athlete in the United States must pass to play a school sport includes listening to the heart, checking blood pressure and reviewing family medical history. Additional testing is typically not done unless a red flag is raised. But many doctors strongly advocate adding an electrocardiogram, or EKG, to the pre-participation exam. They say it would detect about two-thirds of the deadly, concealed heart trouble aggravated by exercise in competition. Sudden cardiac arrest in a young athlete is most commonly set off by a structural heart defect or a problem with the heart?fs electrical circuitry that is not usually found during a routine physical. The most frequent cause is hypertrophic cardiomyopathy, a thickening of the heart muscle. The condition has few warning signs.
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