Few things are more shocking than watching a young, healthy athlete collapse suddenly on the field from sports cardiac arrest. Sudden cardiac arrest during youth sport is rare, but when it happens, survival depends on how bystanders respond in the first few minutes.
What Can Cause Sudden Cardiac Arrest in Young People in Sports?
The intense physical exertion of sports places significant demands on the heart, forcing it to work faster and harder to pump blood throughout the body. For most people, this is entirely safe. However, for young athletes with an undiagnosed heart condition, strenuous activity can trigger sudden cardiac death. The most common underlying heart conditions in sports are:
Hypertrophic cardiomyopathy (HCM) is an inherited condition that causes the heart muscle to become abnormally thick, making it harder to pump blood. HCM affects approximately 1 in 500 people and often produces no symptoms before a fatal event.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited condition where the heart muscle is replaced by fatty or scar tissue which creates dangerous heart rhythm abnormalities during intense exercise.
Long QT syndrome (LQTS) can trigger a chaotic heart rhythm that prevents the heart from pumping blood. LQTS affects approximately 1 in 2,000 people
Wolff-Parkinson-White syndrome (WPW) is a condition where an extra electrical pathway exists in the heart. This can cause episodes of rapid heart rate that can lead to sudden cardiac arrest during exercise.
Outside of underlying conditions, sudden blunt trauma can also trigger sports cardiac arrest. An impact to the chest directly over the heart at the wrong time can disrupt the heart’s electrical activity, becoming a cause of sudden cardiac death.
Warning Signs of Sudden Cardiac Arrest
Sports cardiac arrest often strikes without warning. When symptoms do show, they shouldn’t be ignored as recognising them and taking action can prevent sudden death in the young players.
Fainting or near-fainting. Any loss of consciousness during normal physical activity suggests that the heart might not be working as well as it should.
Unexplained shortness of breath. While getting winded is a normal part of sports, a level of exertion that seems excessive can be a sign of an underlying heart problem.
Chest pain or discomfort. Unusual pain, tightness, pressure, or squeezing sensations in the chest during exercise can be signs of impending cardiac arrest.
Racing or irregular heartbeat. Palpitations, fluttering, or pounding sensations can be a sign of an underlying heart rhythm disorder.
A family history of sudden cardiac death. Athletes with immediate relatives who died suddenly from cardiac causes, particularly at a young age, should undergo thorough cardiac screening before participating in competitive sports.
The DRSABCD Emergency Response
The DRSABCD action plan provides the steps to respond to sports cardiac arrest. Following this procedure guides first aiders through the steps of assessing and treating a person to maximise the chance of survival.
D – Danger: Before approaching the collapsed athlete, quickly assess the scene for any hazards. Check for traffic, ongoing play, fallen equipment, or other dangers that could harm you, bystanders, or the casualty. Your safety comes first. You cannot help if you become a casualty yourself.
R – Response: Once the scene is safe, check whether the person is responsive. Kneel beside them, tap their shoulders firmly, and ask loudly “Can you hear me? Open your eyes.” If they do not respond to verbal or physical stimulation, they are unresponsive and require immediate action.
S – Send for help: Call Triple Zero (000) immediately or instruct someone specific to make the call. Provide the exact location, describe the casualty’s condition, and follow any instructions from the emergency dispatcher.
A – Airway: Open the casualty’s mouth and check for any visible obstructions such as a mouthguard, food, vomit, or blood. If foreign material is present, roll the casualty onto their side, clear the obstruction with your fingers, then return them to their back. Never perform a blind sweep as you can push obstructions deeper.
B – Breathing: Check for normal breathing by looking for chest movement, listening for breath sounds, and feeling for air on your cheek. Take no more than 10 seconds to assess breathing. Occasional gasps are not normal breathing.
C – CPR: If the casualty is unresponsive and not breathing normally, begin cardiopulmonary resuscitation immediately. CPR maintains blood flow to the brain and vital organs until a defibrillator can restart the heart’s normal rhythm.
D – Defibrillation: In instances of sports cardiac arrest, use an automated external defibrillators part of CPR in between cycles of chest compressions and rescue breaths. Follow the voice prompts and visual instructions provided by the device.
How to Perform CPR
CPR combines chest compressions and rescue breaths to circulate oxygenated blood when the heart has stopped from sports cardiac arrest.
Place the casualty flat on their back on a firm surface and kneel beside their chest. Position the heel of one hand on the lower half of the breastbone (sternum), in the centre of the chest. Place your other hand on top of the first hand and interlock your fingers. Keep your arms straight and position your shoulders directly over your hands. Push down hard and fast, compressing the chest to approximately 5cm deep. Deliver compressions at a rate of 1-2 every second for a total of 30 compressions.
After chest compressions, gently tilt the person’s head back with one hand on their forehead, and open their mouth by tilting their chin away with the other. Pinch the soft part of the nose closed using the hand on their forehead, seal your mouth over the casualty’s mouth, and deliver two rescue breaths. If the person’s chest does not rise and fall, either their head is not tilted correctly or there are still instructions.
Continue the cycle of 30 compressions to 2 breaths without interruption. Only stop to use an AED in between, to let someone else take over, if the person recovers, or if you are physically unable to continue.
Using an Automated External Defibrillator (AED)
CPR is enough when someone isn’t breathing, but when their heart has also stopped beating properly during a game then it is a case of sports cardiac arrest and an AED is required. Defibrillation delivers an electrical shock that can reset the heart’s rhythm and restore normal function.
AEDs are designed to be simple enough for untrained bystanders to use. The device analyses the heart’s rhythm and determines whether a shock is needed. It will only allow a shock to be delivered if the heart is in a shockable rhythm like ventricular fibrillation. You cannot accidentally shock someone who does not need it.
To use an AED, follow these steps:
Turn on the AED. Most devices activate when you open the lid or press a power button. Voice and visual prompts will guide you through each step.
Attach the electrode pads to the casualty’s bare, dry chest. Remove clothing from the chest area. The pads have diagrams showing correct placement. Place one pad on the upper right chest below the collarbone and the other pad on the lower left side of the chest, below the nipple and along the side of the ribcage.
Connect the pads to the AED if they are not already pre-connected.
Ensure no one is touching the casualty while the AED analyses the heart rhythm. The device will announce “analysing” and instruct everyone to stand clear.
If a shock is advised, the AED will charge automatically. Ensure everyone is clear of the casualty. Loudly announce “Stand clear” and visually confirm no one is touching the casualty. Press the shock button when prompted.
Immediately after the shock is delivered, resume CPR beginning with chest compressions.
Prevent Sudden Death From Cardiac Arrest in Sports
Sudden cardiac arrest and death in young athletes is devastating, but many of these tragedies are survivable with prompt intervention. Bystander CPR and early defibrillation are the two most powerful tools available to improve survival rates.
Every sports club, school, and community sporting venue should have trained first aiders and accessible AEDs. Parents, coaches, teachers, and players themselves can all learn these life-saving skills. The knowledge and confidence to act in an emergency could save a young athlete’s life.
Completing accredited CPR and first aid training ensures you are prepared to respond . Our HLTAID009 Provide Cardiopulmonary Resuscitation course teaches essential CPR and AED skills, while our HLTAID011 Provide First Aid course provides comprehensive training in managing a wide range of emergencies. Do not wait until an emergency happens to learn how to save a life.
FAQs
How Common are Incidence of Sudden Cardiac Death in Young Athletes?
Sudden cardiac death in young athletes remains rare, with high-quality studies estimating an incidence of approximately 1 to 2 deaths per 100,000 athlete-years. Male athletes face a higher risk of sports cardiac arrest than females, and certain sports with high cardiovascular demands or projectile impacts carry elevated risks.
What Tests Can Prevent Sudden Cardiac Death in Athletes?
An electrocardiogram (ECG) screening can detect many conditions associated with sports cardiac arrest, including long QT syndrome, hypertrophic cardiomyopathy, and Wolff-Parkinson-White syndrome.
What is the Difference Between a Heart Attack and Sudden Cardiac Arrest?
A heart attack is a circulation problem caused by a blocked artery that prevents blood from reaching part of the heart muscle. The person is usually conscious and breathing. Sudden cardiac arrest is an electrical problem where the heart stops beating effectively and the person loses consciousness within seconds. A heart attack can sometimes trigger cardiac arrest, but they are distinct conditions requiring different responses.