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Cardiac Distress in Young Athletes

Every year, millions of young people across the country play sports without experiencing more than minor injuries. But when an otherwise healthy young athlete suddenly collapses during play, it can be a medical emergency.

At the Washington University and Barnes-Jewish Heart & Vascular Center, our heart specialists want to lower the risk of sudden cardiac arrest in young athletes. We offer screening and other services to detect heart conditions and help your child safely participate in sports and other activities.

What Is Cardiac Distress in Young Athletes?

Cardiac distress is a group of heart-related symptoms, including shortness of breath and fainting, that can quickly become life-threatening. Young athletes usually experience cardiac distress during or immediately after competitive sports or other strenuous physical activity. 

The underlying causes are usually previously undetected heart conditions, which cause the heart to beat out of control during exercise. The irregular heartbeat can lead to sudden cardiac arrest (SCA), when the heart suddenly stops beating. Without emergency medical attention, SCA can lead to sudden cardiac death within minutes.

Recognize Signs of Cardiac Distress in Young Athletes

Sometimes, SCA can happen to young athletes without causing any signs or symptoms. Some symptoms can occur with other, less serious conditions such as asthma, so athletes might not notice or report them. 

In young athletes, warning signs and symptoms of cardiac distress usually appear during physical activity. They may include:

  • chest pain or discomfort
  • dizziness or fainting
  • heart palpitations, which feel like the heart is pounding, fluttering, skipping beats or beating too fast
  • shortness of breath
  • unexplained decline in performance or early fatigue with their usual level of exercise

Heart Health Screening for Young Athletes

Screening can identify young athletes at risk of SCA by detecting potentially deadly heart conditions. Because many such conditions are difficult to diagnose, it is important to see a doctor with experience in screening athletes. At the Heart & Vascular Center, our doctors have extensive training and expertise diagnosing and treating athletes with all types of heart disease. 

Our doctors provide sports physicals and pre-participation evaluations for young athletes. We follow the American Heart Association (AHA) screening guidelines, a 14-point checklist that includes a focused medical history and physical exam. 

If we find anything abnormal during the screening, we usually recommend further cardiovascular testing to determine the cause. Learn more about our diagnostic testing for heart disease.

Our specialized Sports Cardiology Program features a specialty-trained sports cardiologist, pediatric cardiologist and other heart specialists. We provide specialized care for athletes and active people to keep them healthy during sports participation. Find out more about sports cardiology.

Personal medical history

Our doctors ask young athletes whether they have experienced certain symptoms or issues. If they are under 18, we ask a parent to verify. As part of the AHA 14-point checklist, the personal medical history items we discuss are:

  1. chest pain, discomfort, tightness or pressure with exertion
  2. unexplained dizziness or fainting
  3. excessive shortness of breath, fatigue or heart palpitations with exertion
  4. heart murmur
  5. high blood pressure
  6. previous restriction from sports participation
  7. previous heart testing ordered by a doctor

Family medical history

We typically review family history with an athlete’s parent to understand possible risk factors. We ask about:

  1. premature (sudden, unexpected) death due to heart disease in one or more relatives before age 50
  2. disability from heart disease in a close relative before age 50
  3. family history of a serious heart condition such as hypertrophic cardiomyopathy, long QT syndrome or arrhythmias 

Physical examination

We perform a complete physical exam, including:

  1. checking blood pressure
  2. listening for a heart murmur while the athlete is lying down, standing and squatting
  3. checking pulses in both arms and legs
  4. looking for signs of Marfan syndrome

Reducing the Risk of Cardiac Distress in Young Athletes

If you are the parent of a young athlete, you can take steps to help protect your child from cardiac distress:

  • Recognize the signs of cardiac distress and SCA: If you notice any unusual health problems during exercise, contact your child’s doctor. If your child experiences serious symptoms, seek medical attention right away.
  • Understand your child’s risk factors: Knowing your family medical history is important, especially if any close relatives have had serious heart conditions.
  • Be prepared: If your child — or anyone else — collapses during exercise or sports, know what to do. Call 911, start CPR and look for a nearby automated external defibrillator (AED).
  • Have your child screened: See one of our specialists for a pre-participation screening for your child before they join a sports team.

Cardiac distress recommendations for schools

At the Heart & Vascular Center, our heart specialists support St. Louis area schools in keeping all students safe and heart healthy. Our cardiac distress prevention and response recommendations for schools include:

  • Train athletes with a graded program to gradually build up their fitness level.
  • Provide plenty of water for athletes during practices and competitions.
  • Ensure that athletes who experience any symptoms of cardiac distress undergo a thorough medical evaluation.
  • If an athlete collapses, respond immediately. Be aware that they may be experiencing cardiac arrest.
  • Provide training for the athletic staff to recognize what SCA during exercise looks like and be able to perform cardiac life support, such as CPR and use of an AED. Ensure that a trained staff member attends every practice and sporting event.
  • Buy at least one AED, and make sure it is easy to access from practice and event fields and courts.
  • Ensure that every athlete undergoes screening with the AHA guidelines. We can review your school’s screening forms and provide evaluations and exams.

Contact Us

To make an appointment with a Washington University cardiologist at Barnes-Jewish Hospital, call 314-362-1291