The beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes — and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone — including a seemingly healthy child.
Ryan Cliff was one of those children. His is a story of survival as he recovered from SCA with the help of University of Michigan C.S. Mott Children’s Hospital doctors. He and his parents share their difficult and emotional experience in Ryan’s video story about his experience of SCA while playing soccer.
If you’re a parent who is concerned about the health of your student athlete, you may want to complete a more comprehensive evaluation form than that typically distributed to high school athletes. And if you answer yes to any of the questions on the detailed health form, be sure your child is examined by his or her pediatrician before participating in any sports program.
Know the facts about sudden cardiac arrest
It’s important to know the facts about SCA, a condition that is often misdiagnosed, as in Ryan Cliff’s case, or not diagnosed at all. Dr. Sharlene Day, U-M cardiologist, shares her expertise here.
Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40 percent of all cases, is hypertrophic cardiomyopathy or HCM.
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition that affects one in 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.
This thickening typically occurs within the left ventricle, which is the heart’s main pumping chamber. The thickening may interfere with the heart’s normal function by:
- Narrowing the outflow of blood from the left ventricle
- Reducing the ability of the heart to relax and fill with blood
- Reducing the ability of the valves of the heart to function properly
Symptoms to look for
Approximately 50 percent of individuals with HCM experience no symptoms. Diagnosis is often incidental or discovered by a combination of ECG, echocardiogram, family history and physical examination by a healthcare professional. Often, the first clue of a HCM condition is a heart murmur.
Hypertrophic cardiomyopathy is complicated because symptoms vary widely both in age of onset and severity. Often, there are mild or no symptoms. The most common symptom is low stamina with shortness of breath and chest pain during exercise. In some, typically during later adulthood, the heart’s chronic overwork causes heart enlargement and symptoms of congestive heart failure.
There is no cure for HCM, and treatment is typically aimed at alleviating symptoms and avoiding complications. This is normally done with medication, such as beta-blockers. If medication does not provide the necessary results, other treatment options are available for some patients, including a septal myectomy, which relieves the obstruction to blood flow exiting the heart. This is performed via open-heart surgery, and the benefits are immediate, improving symptoms in 90 percent of patients. For those with life-threatening heart rhythm abnormalities, a pacemaker or implantable Cardioverter-Defibrillator may be necessary to prevent sudden cardiac death. Those with the most severe symptoms may be candidates for a heart transplant.
Dr. Sharlene Mary Day practices general cardiology and is the director of the Hypertrophic Cardiomyopathy Program at the University of Michigan. She recognizes the importance of healthy eating and regular exercise, and is conducting an exercise training study in patients with hypertrophic cardiomyopathy to measure the importance of fitness in patients with this condition.
The University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at umcvc.org.