deaths due to heart attack The number of college athletes has been steadily declining over the past 20 years, according to a new study.
An analysis of data from more than 2 million NCAA athletes revealed that 143 had died after cardiac arrest that occurred while playing their sport and that there was a wide variation in the risk of death after sudden cardiac arrest, depending on the player race. , gender and sports, according to research presented Monday at the American Heart Association’s annual meeting.
“We don’t know why the rate of deaths from cardiac arrest has been declining,” said study co-author Dr. Kimberly Harmon, a professor in the departments of family medicine and orthopedics and sports medicine at the University of Washington in Seattle.
“You could hypothesize that it’s because there are better emergency action plans when there is cardiac arrest, more people who know CPR, and clear access to a defibrillator,” he said. “When someone faints suddenly, cardiac arrest should be considered until evidence proves otherwise.”
The decline could also be due to increased testing, as colleges increasingly require athletes to be cleared to play with a test that includes a electrocardiogram (EKG or ECG)which measures the electrical activity of the heart and can detect dangerous heart rhythms.
“The patterns on an electrocardiogram can also tell a lot about the shape and size of the heart,” Harmon said. “In athletes, we mainly look for electrical or heart muscle diseases.”
Screening that includes an electrocardiogram has been shown to detect between two-thirds and three-quarters of athletes at risk, he said.
Athletes who have an abnormal electrocardiogram may be sent for an echocardiogram, an ultrasound of the organ.
Cardiac arrest in college athletes is relatively rare: In a given year, 1 in 63,000 college athletes die from cardiac arrest, the study found. Harmon’s data showed that in a given year, there were eight sudden cardiac deaths in NCAA athletes.
However, when the researchers analyzed the data by gender, race, and sport, they found that there were some very surprising differences.
Basketball players had a higher risk, 1 in 8,188 in a given year.
“If you look at athletes who played four years, then it’s 1 in just over 2,000,” Harmon said.
Men were at higher risk than women: 1 in 43,348, compared to 1 in 164,504 female college athletes in a given year.
Deaths among black athletes were three times more common than those among white players: 1 in 27,217, compared to 1 in 74,581 in a given year. Sports cardiologists have previously suggested reasons why Black athletes face higher risk of cardiac arrest It could include genetics, lifestyle and the sport they play.
What causes cardiac arrest in athletes?
The autopsies did not find heart defects in the majority of those who died. The most likely thing in these cases was an electrical short, Harmon said.
“When the electrical activity of the heart is not coordinated, it trembles and does not pump blood and the person faints,” he added.
The study did not look at how many athletes suffered cardiac arrest and survived, something researchers hope to explore in the future.
What’s surprising about the study is that although the incidence of sudden cardiac death is low overall, in certain populations it is less rare, said Dr. Mary Ann McLaughlin, director of cardiovascular wellness at Mount Sinai Fuster Heart Hospital in New York City. .
McLaughlin was surprised by how high the rate of sudden cardiac death was in basketball players and speculated that it might be due to stress on the heart as the players ran up and down the court.
Should all high school and college athletes be tested before being allowed to participate on sports teams?
It’s complicated, experts said, because some athletes and their families may not have the ability to pay for physical exams, especially those that include an electrocardiogram.
“We don’t think it should be a barrier to participation because being on a team has a lot of physical and emotional benefits,” Harmon said.
The new study underscores the importance of schools having an easily accessible defibrillator (which can get the heart beating again) and a team trained to deal with cardiac arrests, said Dr. English Flack, associate professor of pediatric cardiology at Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center.
It was also “quite reassuring to see that the incidence of sudden cardiac death has gone down,” he said. “The next reasonable question is why and how. “Either the cardiac arrest rate has stayed the same and the number of athletes being rescued has increased or the cardiac arrest rate is decreasing due to increased screening.”
The focus should be on ensuring every school has an automated electronic defibrillator and equipment that can help resuscitate an athlete in cardiac arrest, Flack said.
“Many schools can’t afford an AED,” he said.
McLaughlin would also like to see screening rates increase: “The risks associated with performing a physical examination and electrocardiogram are very low compared to the potential benefit of saving a life in someone who is at risk of sudden death.”