Back to school: How to protect kids and student athletes from cardiac arrest, heatstroke

Caption

An emergency defibrillator, used to treat life-threatening conditions that affect the rhythm of the heart such as cardiac arrhythmia, hangs on a wall.

Credit: AP Photo/Seth Perlman

Bronny James, the eldest son of NBA all-time great LeBron James, suffered a cardiac arrest on Monday while working out with his new teammates at the University of Southern California in Los Angeles. And earlier this year here in Georgia, a Mercer soccer player died from cardiac arrest while playing a pickup game. The condition is not unheard of. In fact, it's the leading cause of death in young athletes. Dr. Michael Ackerman with the Mayo Clinic joins me now to talk about cardiac arrest as student-athletes return to practice all over Georgia.

Orlando Montoya: Thanks for joining me, Dr. Ackerman. 

Dr. Michael Ackerman: Thanks for having me. Great to be with you. 

Orlando Montoya: When we think about student-athletes and athletes in general, we're thinking about people at the top of their physical game. So how do these players suffer from cardiac arrest? 

Dr. Michael Ackerman:  Well, I think it's important that it's not just athletes. It's really if you are alive and healthy, all of us have a chance of experiencing sudden cardiac arrest. So there's this background, low, low chance. And but we know that in college and in certain sports and in certain types of athletes, men versus women, white versus Black, the numbers are not the same for everybody. So it may be 1 in 80,000 for all athletes and probably all humans who are on college campuses. But it can get as high as 1 in 4,000, 1 in 5,000 chance per year if you are a Black male playing Division-1 university basketball. So it's not a one-size-fits-all risk and it's not just the athlete. 

Orlando Montoya:  What are the warning signs of cardiac arrest? 

Dr. Michael Ackerman: Well, sudden cardiac arrest or SCA, by definition, is a near instantaneous faint, followed by not waking up on your own within 10 seconds — meaning you faint, you suddenly collapse. You're not waking up. You now need activation of the emergency action plan: Call 911. Push chest compressions fast and get that external defibrillator. Apply it and deliver the shock if instructed to do so. That's sudden cardiac arrest. And in many people, there are no warning signs for that particular moment in which the collapse happens. Now, there could be a warning sign that might have happened in that person two years ago. They might have had an exercise-triggered faint, and they woke up 10 seconds later on their own. So and if that went unrecognized and unevaluated, then the next episode may be far more dramatic than just self-limiting faint. So somebody who's had a sudden, out-of-the-blue exercise-triggered faint, that's not just a warning sign of a faint. That's a warning sign for the possible future sudden cardiac arrest. 

Orlando Montoya: What can schools and coaches do to increase safety to make it safer for student-athletes?

Dr. Michael Ackerman:  Oh, I think it's really starts with awareness and readiness. You know, an ounce of prevention is a pound of cure. And so you're starting to see what I call sudden death safety nets being set up everywhere. So if you don't know of an athlete or an artist or an academic health status because they've had no warning signs and maybe a screening program would or would not detect them, then what you want to do is that if anybody collapses on campus, whether it's the student-athlete, the academic student or the custodian, that whoever collapses, wherever they collapse, there would be an emergency action plan readied and activated and rehearsed. Those programs that have it in place — casinos do an amazing job; it's hard to die suddenly in casinos because they have an action plan. No matter how much money you lose, it's hard to die suddenly in an airplane or an airport because they have the AED plan readied and in place. So having — making it hard to die suddenly in your community, in the public square, is one of our best strategies for the unknown event. The other is finding those who are at risk, getting them treated effectively so that that safety plan will never need to be executed for that person because you know about them. 

Orlando Montoya: Are we seeing an increase in cardiac events for kids? And what, if any, role does COVID-19 or long COVID play?

Dr. Michael Ackerman:  Yeah, great question. You know, the COVID and the vaccine for COVID is being linked to everything. And I think this has been utterly irresponsible with respect to young people dying suddenly as if they're dropping like flies left and right because of the jab — it's absolute nonsense. It's actually quite cruel from my standpoint for that messaging, because in our program at Mayo Clinic, I've been taking care of sudden cardiac arrest survivors for decades now, long before this thing called SARS-CoV-2 even existed, and long before there was a thing called the vaccine for it. And in those who are genetically predilected, there should have been more episodes happening left and right, because my patients are already primed for an electrical episode. And yet we saw absolutely zero — ZERO — increase in events in the three years of the epidemic, pandemic, and in the three years before it. No difference. So, you know, the virus and the vaccine might get credit or blame for some things, but it deserves neither credit or blame for these sudden cardiac arrests from my vantage point. 

Orlando Montoya: And before I let you go, just to change the subject a little bit to heatstroke: I know a lot of parents and coaches are concerned about that. What are some warning signs that people should be looking for on heatstroke? 

Dr. Michael Ackerman: All healthy people should be staying well-hydrated if they're out on 80-degree, 90-degree, 100-degree days. All healthy people should be doing 80 to 120 ounces, if possible, of noncaffeinated, nonalcoholic beverages like water. Important in the summer. Two-a-day — football two-a-days that will start happening in Southeast United States and other places. It's just really important to stay hydrated. But people shouldn't be scared that the heat will trigger a sudden cardiac arrest. That's incredibly rare. 

Orlando Montoya: Thank you so much for joining me, Dr. Ackerman. 

Dr. Michael Ackerman: Great to be with you. And thanks for doing this.