Sudden Cardiac Arrest and the Black Athlete: A Crisis within a Crisis

The spotlight on sudden cardiac arrest (SCA) among Black athletes grew brighter with the heart-wrenching news of Damar Hamlin’s on-camera cardiac arrest and, more recently, the unfortunate Bronny James incident. These tragedies underscore the pressing need to address this devastating condition, claiming the lives of too many young, vibrant Black athletes.

What is Sudden Cardiac Arrest?

Sudden cardiac arrest (SCA) is a life-threatening condition in which the heart unexpectedly stops beating. This abrupt cessation deprives the body of vital oxygen, leading to loss of consciousness and, if not treated immediately, death.

Within the United States, thousands fall victim to SCA annually. Alarmingly, Black Americans face a higher prevalence compared to their white counterparts. The disparity becomes even more pronounced when observing Division I NCAA basketball players, where Black athletes face a heightened risk, as highlighted in a recent study assessing the incidence in collegiate athletes.

Causes of SCA in Athletes

The reasons behind SCAs in young competitive athletes primarily encompass structural and electrical anomalies of the heart. Enlargement of the heart muscle not related to chronic diseases such as high blood pressure (hypertrophic cardiomyopathy), an anomalous origin of the arteries that supply blood to the heart, coronary arteries, and heart muscle inflammation (myocarditis) are among the top causes. These conditions often go unnoticed because they might not manifest significant symptoms until too late.

The Racial Disparity

The disparities in the survival rates of Black vs. white individuals after an out-of-hospital SCA are stark. Black individuals, in many instances, are less likely to receive bystander-initiated essential life support (BLS) than white individuals. This gap in immediate post-arrest care significantly impacts survival rates.

A Way Forward

Addressing this multifaceted problem requires a comprehensive strategy. First, an intensified family medical history screening can be crucial. Given the higher prevalence of certain inherited cardiac conditions within Black communities, selective genetic screening can unearth hidden dangers.

Incorporating routine electrocardiograms (ECG) and echocardiograms into pre-athletic testing can make a significant difference. These tests, in conjunction with standard history and physicals, can spot potential heart abnormalities early.

Furthermore, improving outcomes after an out-of-hospital SCA necessitates community-level interventions. Increased BLS education can empower bystanders to act swiftly and effectively during emergencies. Moreover, making automated external defibrillators (AEDs) more accessible, especially in public parks within communities of color, can be a life-saving initiative.

The Role of Wearable Technology

In today’s age of technology, ECG-based wearable devices may hold the key to proactive cardiac health management. These gadgets can continuously monitor heart rhythms, potentially identifying life-threatening heart conditions before progressing to critical stages.

The crises of SCA among Black athletes, compounded by racial disparities in post-arrest care, necessitate urgent attention. Through intensified screening, widespread BLS education, increased accessibility to AEDs, and leveraging wearable technology, we can take definitive steps towards safeguarding the lives of our young Black athletes. After all, their heartbeats are the rhythm of our future, and we must do everything possible to ensure they keep beating strong.

Contributed by Dr. Matthew Jones MD, FACC, FSCAI