“The leading cause of death among young athletes is not head injury or trauma during sports, but sudden cardiac arrest,” says
Dr. Jonathan Drezner, a UW Medicine family physician who specializes in sports medicine. “In fact, on average, every three days in the U.S., a young athlete dies during training or play from sudden cardiac arrest.”
What is sudden cardiac arrest?
“Sudden cardiac arrest occurs when the heart loses its normal rhythm and stops beating. Unless the person is quickly resuscitated, it is fatal,” Drezner says. “The conditions that put young athletes at risk for sudden cardiac arrest are fairly common.”
Who is at greater risk for sudden cardiac arrest?
As many as one in 250 to one in 300 young athletes have a heart disorder that may increase their risk of sudden cardiac arrest. In some cases, these disorders are inherited and sometimes they are ‘acquired’. For example, viral infections of the heart muscle, called myocarditis, increase the risk for sudden cardiac arrest.
“The majority of people with these heart disorders will never have problems, but an important subset of athletes will. If we identify the athletes with these conditions, we can reduce their risk of sudden cardiac death — sometimes with medication, a procedure or with a device,” Drezner says.
In addition, Drezner says, “Sudden cardiac arrest in athletes is more common among males; African Americans; and, while we don’t know why, basketball players, regardless of their race or ethnicity.”
What are the warnings signs of sudden cardiac arrest?
“Most athletes who have had a sudden cardiac arrest didn't display symptoms beforehand, and few have physical signs that would be detected with a routine sports physical. So, over the past three years we’ve done electrocardiograms, or EKGs, of nearly 8,000 high school student athletes in the greater Seattle area. Of them, we have identified about 30 students with one of these high-risk heart disorders,“ says Drezner.
Signs of sudden cardiac arrest include:
- Fainting or lightheadedness during exercise
- Chest pain/discomfort during exercise
- Heart racing, skipping a beat, palpitations during exercise
- Shortness of breath more than your friends
- Tire more easily than friends
- Unexplained seizure activity
- Decrease in physical activity, new onset of fatigue
- Family history of a relative having a heart problem at a young age, less than 50
Who should be screened for heart disorders?
“Ideally, all young athletes would receive EKG screening,” says Drezner. “It takes special expertise to interpret EKGs and distinguish any changes that are due to training, from changes that might be a result of a pathologic condition. So, one reason we are launching the UW Medicine Sports Cardiology Program at Husky Stadium is to create a place where any athlete can come to be screened.”
“When I first got started in this area of research, my focus was on improving resuscitation of young athletes when they had sudden cardiac arrest. This involved training people in resuscitation and the targeted placement of automated external defibrillators, or AEDs. AEDs located in sports facilities and schools greatly improve the chances of survival,” says Drezner. “But resuscitation isn’t always successful. Even when it is, there’s a risk of brain damage. So now we’re focusing on expanding screening to see if we can identify those young athletes who are at risk and prevent more cases of sudden cardiac arrest before they occur.”
Sports cardiology services are located at the new UW Medicine Sports Medicine Center at Husky Stadium. Learn more at
UWMedicine.org/sports-medicine or call 855-520-5151 to schedule a heart screening.
UW Medicine Health: How did you become interested in sports medicine?
Drezner: “In medical school, I was interested in all aspects of medicine and that drew me to family medicine. But I was an athlete growing up, played college basketball at Brown University, and we had sports medicine doctors caring for the team. That experience made me want to be a team physician. When I realized that I could do both — family medicine and sports medicine — it was a no-brainer that would be my career path.”
UW Medicine Health: Why did you choose to practice at UW Medicine?
Drezner: “UW Medicine is a wonderful place to practice. Its mission includes not only clinical excellence, but also education and innovative research. It’s a great academic environment, and UW Medicine leadership has been extremely supportive of our efforts to try to prevent sudden cardiac arrest in young athletes.”