sports cardiology


Sports Cardiologist on Takeaways from Bronny James’ Cardiac Arrest: Still a Rare Event But Vital Awareness is Growing

Baptist Health Miami Cardiac & Vascular Institute

Bronny James, 18, the prominent basketball freshman at USC, and son of NBA star LeBron James, lost consciousness during a workout at the Galen Center on Monday and was treated for cardiac arrest. He is in stable condition after a brief stay in the intensive care unit, according to a statement from the James family.

Are incidents of sudden cardiac arrest among young athletes becoming more common? And should parents worry? Parents should be vigilant but they shouldn’t be concerned about such a trend, explains
Eli Friedman, M.D., medical director of sports cardiology at Baptist Health Miami Cardiac & Vascular Institute.

Eli Friedman, M.D., medical director of sports cardiology at Baptist Health Miami Cardiac & Vascular Institute.

Dr. Friedman is spearheading programs to help diagnose or treat cardiovascular conditions in athletes – and active individuals at all ages -- across South Florida, and help train athletes and their coaches and trainers in proper CPR techniques in school and college athletic programs.

“This is a rare event,” explains Dr. Friedman. “The temptation to think this is happening more often is due to increased awareness in the social media age, and with several high profile, public cardiac arrests in sport recently.”

In the U.S., well-known professional basketball, football and baseball players are competing with heart conditions requiring close monitoring. Most strikingly, the field of sports cardiology gained worldwide attention on Jan. 2 in Cincinnati when Buffalo Bills defensive back Damar Hamlin, 24, suffered sudden cardiac arrest after a tackle and was revived after extensive CPR and the use of an AED (Automated External Defibrillator), a device that delivers an electric shock to restore normal heart rhythm.

“The event rate is likely somewhere between 100-150 deaths related to sports annually in the U.S., though it’s hard to know as we do not have a good way of capturing the true numbers,” said Dr. Friedman. “There are some suggestions in the data that these happen in clusters – meaning that we will see increased numbers for a year or two, and then it will quiet down.”

The Bronny James incident represents the second time a USC freshman basketball player suffered cardiac arrest while practicing. Vince Iwuchukwu returned to the court six months after his cardiac arrest on campus last year.

“LeBron and Savannah wish to publicly send their deepest thanks and appreciation to the USC medical and athletic staff for their incredible work and dedication to the safety of their athletes,” the James family said in a statement.

Here are more insights from Dr. Friedman:

What causes sudden cardiac arrest?
Dr. Friedman: “It’s multifactorial. It can certainly be cardiac related -- structural, electrical or acquired heart disease. This includes things like hypertrophic cardiomyopathy, valvular heart disease, problems with the heart's electrical pathways, myocarditis, anomalous coronary arteries, and so on. The most common cause of cardiac arrest in young athletes is sudden, unexplained cardiac arrest. This means all testing is completely normal prior to and after the event."

What should/can parents be doing to protect their young athlete?
Dr. Friedman: “It is very important to be aware of any symptoms that an athlete has that could be a sign of underlying heart disease. Things to look out for include exertional chest pain or discomfort, abnormal/disproportionate shortness of breath, fainting during exercise, and skipping/racing heart beats. A family history of premature heart disease/sudden death should prompt inquiry to look for underlying inherited heart disease that could be relevant to sports.

“ECGs are not recommended on a mass/public health level, but they can be done on an individual basis with shared decision-making. A preparticipation history and exam are very important and serve as an opportunity to ensure safety. Most importantly, everyone should learn CPR and know how to use an AED. These are rare events that are almost impossible to predict. CPR, AEDs and emergency action plans are the ultimate insurance policy.”

What are the signs that sudden cardiac arrest is happening, and what can adults do?
Dr. Friedman: “Unresponsiveness, no pulse, agonal respirations (deep gasps where it seems as if someone is breathing), seizure-like movements, non-contact collapse -- are all signs of cardiac arrest. If seen, consider it to be cardiac arrest until proven otherwise. Call 911, grab an AED, place the pads and start immediate CPR until help arrives. Follow the prompts of the AED.”


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