What we can learn from Damar Hamlin's cardiac arrest

Whenever cardiac arrest occurs in in such a public way, especially a professional athlete, we think about what can be done to prevent these episodes. Surely there must be a way to test for conditions that cause it.  Even HBO’s Real Sports has done a segment on awareness of Sudden Cardiac Arrest (SCA).

First, we must understand that SCA can happen to anyone. People with structural heart disease or other chronic illnesses have a higher risk of arrhythmias. Young people are especially at risk of sudden cardiac arrest for certain conditions. According to Mayo Clinic’s website, heart conditions that can cause SCA include:

• Coronary artery disease
• Heart attack
• Enlarged heart called cardiomyopathy
• Heart valve disease
• Congenital Heart Defects
• Long QT syndrome (LQTS) Wolff Parkinson White syndrome (WPW), and other heart signaling problems.

Many organizations have formed out of the loss of a child that campaign for laws to help raise awareness and mandated screening of all youth. While there is some validity to their desires, the method of testing leaves many medical professionals to question the effectiveness.  The American Heart Association recommends all athletes complete a 12-point questionnaire. The International Olympic Committee recommends a targeted personal and family history, physical examination, and 12-lead ECG for all sports participants at the beginning of competitive activity, and to be repeated every 2 years there-after.

The National Football League players are intensely screened, utilizing multiple tests. This is different from widespread screening of high school and college athletes with only an ECG. ECG’s are best at diagnosing electrical conditions but when it comes to structural abnormalities, they are suspect at best. The Gold Standard in structural diagnosis of the heart is an echocardiogram (heart ultrasound) which is used extensively by professional sports teams along with ECG’s and a family/personal history review.

Conclusions

As long as there are sports, there will be athletes, and kids, who suffer cardiac arrest.

We will continue to follow Hamlin’s recovery and learn lessons to help reduce the rate of death from SCA. The opposition by the American Heart Association and American College of Cardiology to voluntary cardiac screening of youth needs to be revisited and reviewed. However, the concern over ECG only screenings does have its validity. There are alternatives to safely and effectively screen kids for undiagnosed heart conditions that are not limited to only ECG’s.