Sudden cardiac death—when sports turn deadly

  • Shelly Webb
  • February 11, 2012
  • 326
                        
Summary- Kids play sports everyday. Some are avid baseball or softball players; others enjoy hockey, soccer or some other competitive game. But a hit in the chest at just the right moment could be a real game changer. Story- According to recent data from the registry of the Minneapolis Heart Institute Foundation, a condition known as commotio cordis is one of the leading causes of sudden cardiac death in young athletes. The number one causes include hypertrophic cardiomyopathy and congenital coronary artery abnormalities, which we explored at length in last week’s health feature. Commotio cordis however is another cardiac condition and one that ranks high on the list of why young hearts stop beating. When commotio cordis occurs it puts the heart into what is known as ventricular fibrillation (VF), which leaves the heart with an abnormal heart rhythm. VF then causes a useless quivering of the heart which results in a complete halt of circulation. With no blood pumping or flowing through the body, the result is sudden death. Pediatric cardiologist, Dr. Kenneth Zahka of Pomerene Hospital said the issue surrounding commotio cordis is getting hit in the chest at precisely the right time, which can be within a .02 second range. “If you take a blow to the chest at that exact second, the heart rhythm can be disrupted,” he said. “This is rare, but can happen when a baseball, hockey puck, soccer ball or some other projectile hits the chest at a very fast rate. This has occurred in recreational sports as well as competitive sports.” In the past, the rate of resuscitation when this situation occurs has been low, however it is improving. Also commotio cordis instances usually involve impact from a baseball, but in recent years there have been cases related to hockey, softball, lacrosse, karate, and other sports activities. Nearly 250 cases have been reported to the National Commotio Cordis Registry to date, but officials suspect a higher incidence of cases may go unreported. Protecting the chest with a chest protector is an option that some individuals use, but according to Dr. Zahka these mechanism do not alter the outcome. “Chest protectors do not help when commotio cordis occurs,” he said. “The most important thing to address this problem is having access to an AED (automated external defibrillator). These machines are true lifesavers and can also help resuscitate those with other genetic type heart problems. Time is the main factor, it’s all about how soon you can get to someone. There have been many students saved by AEDs and even grandparents and parents at sporting events have been saved because an AED was available.” In a cardiac emergency you normally have between two and three minutes to resuscitate an individual. AEDs are easy to use and are more affordable today than ever before. The computer inside the device analyzes the heart rhythm and advises the operator whether a shock is needed. AEDs advise a shock only in circumstances where one is needed. The electric current is delivered through the victim's chest wall, via adhesive electrode pads. The shock will then hopefully restore the victim’s normal heart rhythm. AEDs are safe and simple to use and will only shock someone who does not have a pulse. The directions are displayed on all AEDs and are easy to follow. AEDs first began making appearances in public schools after a teen from New York died due to commotio cordis while playing in a high school lacrosse game. Louis Acompora died on March 25, 2000, while playing goalie and wearing a required chest protector. When Acompora blocked a routine shot with his body it resulted in a lacrosse ball striking his chest directly over his heart. In a millisecond his heart was thrown into ventricular fibrillation. Most observers at that game suspected that he was recovering from the discomfort of the blow when he collapsed to the ground. To the shock of the coach, bystanders and his parents, Louis was unconscious, not breathing, and had no pulse. Rescuers at the scene administered cardiopulmonary resuscitation (CPR). However, defibrillation was not administered for well over 12 minutes following the collapse and Acompora died. “Louis’s Law” is what started bringing AEDs into schools. His parents, Karen and John Acompora fought for a law that would implement placing these devises throughout public schools, first in New York and then in other states. To date more than sixty people have been saved thanks to “Louis’s Law”. AEDs are much more common in many public places these days and can be easily used. Making sure there is access to an AED at your school or organization is important and is something that can mean the difference between life and death.


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