HOUSTON – (Aug. 9, 2010) – Back-to-school means a return to
academics and to athletics and sporting activities. Texas Children's Hospital recommends
that young children and teens whose families have a history of heart disease receive
more than a routine "back-to-school" exam before playing sports.
And although sudden cardiac death is rare -- affecting about
15-25 young athletes per year -- it's good for families to know the facts.
"First of all, sudden cardiac death is not a heart attack,"
said
Douglas Moodie, M.D., interim chief of pediatric cardiology at Texas Children's
Hospital. "It is a sudden stopping of the heart, which results in death within minutes.
Usually it is caused by a previously undiagnosed heart disease or disorder."
In most cases, sudden cardiac death is due to a malfunction
of the heart's electrical system, which coordinates the contracting of the heart
muscle to pump blood through the body. The lower chambers (ventricles) of the heart
go into a fast and disorganized contraction, called fibrillation. The ventricles
spasm or quiver and can no longer pump blood to the body. The heart cannot recover
from ventricular fibrillation on its own. It needs to be "shocked" back into rhythm,
usually by an automated external defibrillator (AED).
"There are many causes for sudden cardiac death in childhood
and adolescence," said Dr. Moodie who pointed out that the vast majority of these
disorders, which are listed below, are mostly unsuspected and without obvious prior
symptoms.
- Hypertrophic cardiomyopathy is the most common
cause for sudden cardiac death in athletes in the United States. In this hereditary
condition, the muscle mass in the left ventricle grows abnormally large (hypertrophies).
The thickened heart muscle blocks blood flow out of the heart, increasing risk of
ventricular fibrillation.
- Coronary artery abnormalities are present at birth,
but they can be silent for years until a person performs vigorous exercise. An abnormality
of the vessels that supply blood to the heart muscle causes the heart muscle to
be impaired during exercise, resulting in ventricular fibrillation.
- Commotio cordis are rare injuries that cause a
concussion of the heart, setting off ventricular fibrillation. Usually they occur
when someone is hit in the area of the heart by an object such as a baseball, softball,
hockey puck or even a fist.
- Marfan syndrome is an inherited abnormality of
the connective tissue (ligaments and tendons) in the body. People with this condition
often are tall and thin with long arms, legs, fingers and toes. The wall of the
aorta, the main artery from the heart, can become weak and rupture, especially during
exercise.
- Wolff-Parkinson-White syndrome is caused by an
extra conduction fiber in the heart that can allow for rapid heart beat episodes.
In some cases, ventricular fibrillation occurs.
- Long QT syndrome is an inherited abnormality of
the heart's electrical system. Episodes of rapid heartbeats can occur in the bottom
chambers of the heart (ventricles), resulting in ventricular fibrillation.
- Myocarditis is inflammation of the heart muscle
caused by viral or bacterial infections that reach the heart.
- Recreational drug use can trigger ventricular fibrillation
in a person with a normal heart.
Even though your child's chance of suffering sudden cardiac
death is rare, it's a good idea to watch them for warning signs. If your child experiences
any of the following symptoms while exercising, have her or him examined by a healthcare
professional before they participate again in exercise or sports.
- Palpitations (fast or skipped heartbeats)
- Dizziness or lightheadedness
- Chest pains or chest tightness
- Shortness of breath
- Fainting or passing out
"If a parent, teacher or coach sees a student athlete experiencing
any of these warnings signs – particularly fainting during or just after sports
or chest pains during exercise, they should see that the student gets a proper cardiac
evaluation by a qualified physician," said Dr. Moodie. "Also, it is vitally
important to know the family history to determine if aunts, uncles or cousins in
the family experienced sudden death, or have a cardiomyopathy or electrical problem
(called an arrhythmia) of the heart. These serious heart conditions are not easily
picked up in most of the back-to-school physicals where no cardiologist is listening
to the heart."
Parents also can prepare for a healthy school year by ensuring
their child has healthy sleeping habits, eats a nutritious breakfast and lunch,
and is mentally prepared to go back to school.
Get more back to school tips.
About Texas Children's Hospital
Texas Children's Hospital is committed to a community of healthy children by providing
the finest pediatric patient care, education and research. Renowned worldwide for
its expertise and breakthrough developments in clinical care and research, Texas
Children's is ranked in the top 10 best children's hospitals by U.S. News and World
Report. Texas Children's also operates the nation's largest primary pediatric
care network, with over 40 offices throughout the greater Houston community. Texas
Children's has embarked on a $1.5 billion expansion, Vision 2010, which includes
a neurological research institute, a comprehensive obstetrics facility focusing
on high risk births, and a community hospital in suburban West Houston. Get the
latest Texas Children's news on Twitter:
www.twitter.com/texaschildrens.
