Disconcerting Cardiac Arrest Mortality in Athletes

A new study found that sudden cardiac arrest was fatal in eight of nine college athletes who had observed events, despite the rapid efforts of athletic trainers, emergency medical services (EMS) personnel, and the ready availability of automated external defibrillators.

Dr. Jonathan A. Drezner, M.D, of the department of family medicine at the University of Washington (Seattle, USA), and Dr. Kenneth J. Rogers, Ph.D., of the department of orthopedic surgery at the University of Pennsylvania (Philadelphia, USA), examined nine witnessed sudden cardiac arrest cases among college athletes from 1999 through 2005. There were four basketball players, two football players, two lacrosse players, and one swimmer. All involved men and the average age of athletes was 21 (range 18 to 30). Five of the athletes were African American.

The most common cause of arrest was hypertrophic cardiomyopathy, which led to five of the eight deaths. Two lacrosse players suffered arrest caused by the deadly blow to the chest known as commotio cordis, and a 30-year-old African-American basketball player suffered sudden cardiac death triggered by a myocardial infarction (MI).

Cardiopulmonary resuscitation was initiated within 30 seconds of arrest in six patients and in less than one minute after arrest in two others. In five of the nine young athletes, the automated external defibrillator was provided by the athletic trainer and in four cases it was supplied by EMS. In seven of the nine patients, shock was deployed, and the average time from arrest to defibrillation was 3.1 minutes. Despite this, death resulted in eight of the nine athletes. The results were reported in the July 2006 issue of Heart Rhythm.

"Structured and practiced emergency response plans are needed at university and public sporting venues. With increased public and rescuer education in the recognition of cardiac arrest, new guidelines for cardiopulmonary resuscitation [CPR] and emergency cardiovascular care, and increasing availability of automated external defibrillators, the potential for limiting these catastrophic events in young athletes remains promising,” concluded the authors.





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