Sudden Cardiac Death in Young People

Football_downSudden death in young people is rare. Almost always, it is due to a hidden birth defect, an overlooked heart abnormality, or an undiagnosed tumor that causes a hormonal imbalance. When sudden deaths to young people do occur, it’s often during physical activity, such as a sporting event. It can happen without any warning, but often there are signs and symptoms that offer clues and introduce an opportunity for prevention.

The causes of sudden cardiac death in young people vary. For a variety of reasons, something causes the heart to quiver instead of beat. This abnormal heart rhythm is known as ventricular fibrillation or V-fib.

Some specific causes of sudden cardiac death in young people include:

  • Hypertrophic cardiomyopathy (HCM). This is a disease in which the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. Hypertrophic cardiomyopathy, while usually not fatal in most people, is the most common cause of heart-related sudden death in people under 30, including the sudden death in athletes.
  • Coronary artery abnormalities. Sometimes people are born with coronary arteries that are connected abnormally. The arteries can become compressed during exercise and may not provide proper blood flow to the heart.
  • Long QT syndrome. Long QT syndrome is an inherited heart rhythm disorder that can cause fast, chaotic heartbeats which can cause fainting (syncope) or death. This is one of several sudden arrhythmia death syndromes (SADSs).
  • Brugada syndrome. Like long QT syndrome, this is a life-threatening abnormality of the heart’s electrical system. Here is more info about Brugada syndrome from the Mayo Clinic. This is another SADS.
  • Structural abnormalities of the heart. These structural abnormalities include unrecognized congenital heart disease and heart muscle abnormalities.
  • Inflammation of the heart muscle, caused by viral infections and other illnesses.
  • Commotio cordis. The result of a blunt blow to the chest, such as being hit by a baseball or hockey puck, at just the right time. The blow to the chest can trigger ventricular fibrillation if the blow strikes at exactly the wrong time in the heart’s electrical cycle.

Many times these deaths occur with no warning, but symptoms to watch for include:

  • Unexplained fainting (syncope). Sudden and unexplained fainting that occurs during physical activity could be a sign that there’s a problem with the heart.
  • Family history of sudden cardiac death. The other major warning sign is a family history of unexplained deaths before the age of 50. This obviously isn’t a physical symptom like fainting, but deaths like this in a family history should prompt athletes and parents to pay close attention and perhaps talk with the family doctor about screening options.

Shortness of breath or chest pain may also be a symptoms of a risk of sudden cardiac death, but these may also indicate other health problems in young people, such as asthma.

To learn more about sudden death among young people, follow these links: