The biggest killer of young athletes: Sudden cardiac arrest
It was the first pre-season scrimmage of the basketball season at Red Bank Regional High School in Little Silver, N.J. Proud mother Tracy Dixon arrived late on Dec. 3, 2012. When she arrived, she saw her son trembling on the gym floor.
No one could miss 17-year-old Albert Martin, also known as “Biggie.” He stood 6-foot-5, had a size 17 shoe and could usually be found in the park perfecting his jump shot. Leading up to December 2012, his senior year season, Martin cut down on junk food and dropped 90 pounds to improve his moves on the court.
But weight wasn't his only problem. Martin suffered from hypertrophic cardiomyopathy, an enlarged heart. Without warning, Martin’s heart stopped pumping blood that day as he played the sport he loved.
"I run over there and I said, 'Biggie, Biggie, mommy here, mommy here,'" Dixon told America Tonight. “And he turned over on his stomach like he was trying to get up and I was like, 'No, don’t get up. Don’t get up.'"
Those were the last words the mother spoke to her son. “You know they always say the hearing is the last to go,” she said. “He did see me before he closed his eyes. He knew I was there.”
Martin was rushed to the hospital and pronounced dead later that day. "To see him laying there, no more Albert," his mother said. "No more hugs. No more smiles. No more nothing."
Sudden cardiac arrest is far more common among young athletes than previously thought, according to research published by the American Academy of Pediatrics in 2012.
"Heart issues represent about three quarters of the deaths on the playing field," said Dr. Jonathan Drezner, a leading researcher in the field of orthopedic and sports medicine at the University of Washington and a team physician for the Seattle Seahawks. “Most of the athletes who die on the playing field from a heart condition have no warning symptoms."
Protecting young athletes
The problem usually lies in an undetected physical defect in the heart, and symptoms like dizziness are easily dismissed.
There's no mandatory reporting on the frequency of sudden cardiac arrest or sudden cardiac death among young athletes in the U.S., but one study reported that the frequency of sudden death in young competitive athletes was about 110 deaths per year, or about one death every three days.
That statistic could change, however, thanks to the electrocardiogram (EKG), an advanced heart screening. Electrodes are placed on the patient’s arms, legs and chest, and a machine traces the person’s heart activity onto paper. If Martin had undergone an EKG in his high school basketball career, it might have found an abnormal signal.
An EKG is not usually a standard part of a young athlete’s physical, but Drezner said it is very important. Without it, he said, many underlying heart conditions go undetected.
“If we have an evaluation that is based predominantly asking [an athlete] if they have heart-related symptoms, we will miss the majority of kids at risk,” he said.
An EKG can help protect athletes, but a trained physician should be the interpreting the results, he added. “Once you know how to interpret an EKG in a young athlete – adding that to your history or [your] physical – greatly improves your ability to detect someone who has a potentially lethal heart issue,” he added.
Tracy Dixon
Albert Martin's mother
Hundreds of groups offer free EKGs at community screenings, reported The New York Times. But the American Heart Association opposes universal, mandated screenings, believing the condition is too rare to justify the cost. Dixon makes sure takes her daughter, a track star, to get an EKG test every year. But Drezner said EKGs would be difficult to mandate.
“We don’t have a physician infrastructure that’s capable to absorb the U.S. high school population – or even the college population – but I think we are making great strides at educating our physicians on how to interpret this.” Drezner, who said the added cost is worth the benefit, added: “I think certain high risk groups, for instance, our basketball players in college, some of our male athletes, African American athletes - starting with our highest risk groups first - might be the way to go and start to implement more widely available [EKG] screening.”
An Automatic External Defibrillator, a portable device capable of transferring an electric shock to the heart, has also proven to be effective in sudden cardiac arrest situations on high school campuses.
Drezner recently compiled and published the results of a two-year study aimed at determining how effective Automatic External Defibrillators can be in the case of sudden cardiac arrest on school campuses.
In the study, Drezner’s research team, which observed more than 2,100 high schools between 2009 and 2011, found that one in 70 high schools will have a case of sudden cardiac arrest happen on campus every year. The study found that almost half of the incidents will involve students or student-athletes.
Although Martin could not be saved with an AED, Drezner’s study found high school AED programs demonstrate a “high survival rate for students and adults who suffer sudden cardiac arrest on school campus.”
Today, almost a year since his death, Martin lives on in the form a redwood tree, planted in his honor near the basketball court. The high school selected a redwood because it will one day reach 200 feet – a fitting memorial for Biggie.
Correction 01/21/14: A previous version of this article stated that Tracy Dixon's name was Tracy Martin.
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