Q: [School-Aged] You hear these tragic stories of kids who suddenly drop in the middle of a game or match, passing away from heart issues. Is this genetic? Is it from the heat or overworking during practice? I know the odds of anything like that happening are remote, but is there anything the parents can do?
A: Thank you for the question. Definitely excess heat, overworking and exhaustion can impose health risks. However, it sounds like what you are thinking of is sudden cardiac death (SCD) from unknown pre-existing cardiac disease. The chances of these SCD events are rare and many times there is a genetic component.
If you recall the Loyola Marymount basketball player, Hank Gathers, who died in 1990 while playing at the West Coast finals tournament, he had hypertrophic cardiomyopathy (HCM), which is an abnormal thickening of the heart muscle. This is a genetic condition that affects 1 in 500 individuals and is the most common cause of SCD in young athletes.
There is another genetic condition that affects electrical condition in the heart called Long QT Syndrome (LQTS). This affects 1 in 2000 to 1 in 4000 individuals. Apart from these, there are a few other genetic and anatomic conditions which can cause sudden cardiac death, but are exceedingly rare.
In addition to routine check-ups with the general pediatrician that includes a thorough history and physical exam, I would also recommend a pre-participation sports screening electrocardiogram (ECG). Although there is still some controversy regarding the utility and cost/benefit of ECGs, this is what most pediatric cardiologists recommend. This can be done at any pediatric cardiology office and most general pediatric offices, as well as through free high school sports screenings offered by various organizations, such as Saving Hearts Foundation.
Dr. James Chu, Medical Director, Pediatrix Cardiology of Orange County, an affiliate of MEDNAX Dr. Chu attended medical school at the University of California (UC) Irvine and received the fellow of the year award at UC San Diego in 2003. www.mednax.com, pcoc.pediatrix.com
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