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Sudden cardiac arrest (SCA) among youth who are fit and active shakes the common belief that only older or sedentary people need to worry about heart health. In fact, young athletes under 35 do face real risks. Understanding the causes, recognizing warning signs and taking practical steps can save lives.
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Anesthetist & IntensivistWhat is Sudden Cardiac Arrest
Sudden cardiac arrest occurs when the heart abruptly stops beating. Blood flow to brain and organs halts. If not treated immediately—within minutes—it leads to death. This is different from a heart attack (myocardial infarction) where blocked arteries damage heart muscle over time. SCA is an electrical/electromechanical problem.
How Common Is It
- Among young athletes (< 35 years), the prevalence of heart conditions that predispose them to sudden cardiac death (SCD) is estimated at 0.2-0.7%.
- The risk during organized training or competitive events is higher than during non-training periods.
- In India, sports-related sudden cardiac deaths are rare but not negligible. A study reported about 4.6 per million population annually for sports-related SCDs.
Major Causes
In young athletes, several heart problems are often silent until triggered by exertion or stress. Key causes include:
| Cause | Details |
|---|---|
|
Hypertrophic cardiomyopathy (HCM) |
Thickened heart muscle, especially in ventricles. This disrupts electrical signalling and can cause dangerous arrhythmias. |
|
Sudden Arrhythmic Death Syndrome (SADS) |
Refers to cases where no structural heart disease is found, but fatal rhythm disturbance occurs. |
|
Coronary artery anomalies |
Abnormal origin or path of coronary arteries may be undetected until stress reveals them. |
|
Arrhythmogenic right ventricular cardiomyopathy (ARVC), myocarditis, ion channel disorders |
These affect structure or electrical conduction. Myocarditis may follow viral infections. Channelopathies affect the heart’s rhythm even without structural damage. |
|
Lifestyle & external triggers |
Dehydration, electrolyte imbalance, extreme exertion, use of stimulants, steroids, performance enhancers. Also issues like obesity, high blood pressure, undiagnosed diabetes add risk. |
Risk Factors You Should Know
You may not have any symptoms, yet risk factors increase the chance of SCA. If you are or coach an athlete, watch for these:
- Family history of sudden unexplained death, inherited cardiac disease, or arrhythmia syndromes.
- Prior fainting, dizziness, palpitations especially with exercise.
- Chest pain during exertion.
- Known heart disease or heart murmur. Maybe silent till stressed.
- High-risk lifestyle: use of performance enhancers, excessive stimulants, steroids. Poor sleep. Chronic stress. Obesity. Undiagnosed hypertension or diabetes.
Prevention: What Works
Preventing SCA in young athletes is possible if certain measures become routine.
- Pre-participation screening
Basic medical history and physical exam. ECG and echocardiogram where indicated. For those with symptoms or family history, more advanced testing. - Educate coaches, athletes, parents
Recognize warning signs: unusual tiredness, chest pain, fainting, heart palpitations. Stop activity and seek medical advice. - Moderate training loads
Gradually increase intensity. Ensure rest and recovery. Avoid pushing beyond safe limits, especially for beginners. - Maintain hydration and electrolyte balance
Drink properly before, during and after training. Monitor for dangerous dehydration. Replace salts lost through sweat when training long or in hot conditions. - Avoid risky supplements, performance enhancers without medical oversight
Some of these can raise heart strain or cause arrhythmias. Use under guidance. - Lifestyle habits
Good sleep. Manage stress. Control weight. Avoid smoking or substance abuse. Screen and treat hypertension, high cholesterol, diabetes early. - Emergency preparedness
Athletes’ venues should have a plan. CPR training for staff and athletes. Access to Automated External Defibrillators (AEDs). Time matters: survival is much higher if CPR and defibrillation start within minutes.
What India Is Doing & What More Needs Doing
- The Punjab government has issued advisories aimed at gym-goers and athletes. These emphasize screening, coaching under supervision, avoiding unsafe supplements, and early recognition of symptoms.
- However, there is need for wider implementation: school sports screening, mandatory basic ECGs before competitive sport, awareness campaigns.
Key Takeaway
Sudden cardiac arrest in young athletes may look rare. But risk is real and often hidden. You may feel healthy. That does not guarantee safety under stress. The good news is many causes are detectable. Many triggers are avoidable.
If you or someone you train shows symptoms (fainting, chest pain, fast or irregular heartbeat), don’t ignore them. Get medical evaluation. Use screenings. Train smart. Be prepared for emergencies.
Your heart is not just a muscle. It is your life’s engine. Protect it.
