American football player Damar Hamlin, 24, suffered a cardiac arrest last Monday (2/1) during an NFL game. Despite being young and healthy, the athlete fell to the ground after crashing heavily with an opponent and is hospitalized in critical condition.
Cardiac arrest happens when the functioning of the heart stops, which results in the absence of circulating blood flow. The problem prevents the blood from taking oxygen to the vital organs and, if not treated, causes the death of the patient.
Although the picture is more common in elderly individuals and with several risk factors, cardiac arrest is not exclusive to sedentary people. Cardiologist Ricardo Teixeira Leal, from Hospital do Coração do Brasil, in Brasília, emphasizes that young athletes can also suffer from the problem. “It usually happens to people in competitive activities that demand a lot”, explains the expert.
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The doctor points out that Hamlin’s case is not isolated. Danish soccer player Christian Eriksen suffered cardiac arrest during a Euro 2020 match against Finland. The midfielder, who at the time was 28 years old, was revived on the pitch.
Leal explains that patients who receive a strong impact on the chest, like Hamlin, can suffer from two problems: comotion cordis and contusion cordis. “Probably, what happened to this patient was the comotion cordis. It is when there is a strong impact on the heart, usually due to a car accident, when the steering wheel hits the chest, or any sport that has a blunt trauma”, says the doctor.
The concussion that happens at a specific moment, when the electrical part of the heart is susceptible to arrhythmias, can interfere with the rhythm of the heartbeats, and the patient can develop cardiac arrest.
In the case of contusion cordis, a contusion occurs in the myocardium when there is a strong impact on the heart muscles. The knock can cause structural damage to the organ, and the weak walls can cause a serious arrhythmia that leads to cardiac arrest.
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previous illness
In the case of genetic problems that can cause cardiac arrest in healthy young people, Leal points out that there are two types of conditions: anomalous origin of the right coronary artery and hypertrophic cardiomyopathy.
The first is a rare heart defect, which has to do with the course of the pulmonary artery. The disease is usually asymptomatic but potentially dangerous if not diagnosed and treated early. The anomaly can cause chest pain, sudden death, heart failure, syncope, dyspnea, ventricular fibrillation, and myocardial infarction. It is estimated that about 1.5% of the general population suffer from the problem.
Hypertrophic cardiomyopathy, on the other hand, has a hereditary genetic cause, and causes a thickening in the walls of the ventricles, the two lower chambers of the heart, which become larger and rigid. The condition is a common cause of fainting, chest pain, shortness of breath and palpitations.
In athletes over 35 years old, the cardiologist also warns of the possibility of heart attacks (the main cause of cardiac arrest), as happened to goalkeeper Iker Casillas, who in 2019, aged 37, had to be rescued during training. “The heart attack may be linked to cholesterol plaques associated with the genetic component. The competition demands greater overload, which can be fatal”, explains Leal.
Prevention
The ideal, according to the doctor, is to follow international protocols that suggest tests before starting activities to anticipate the diagnosis and avoid problems.
The cardiologist recalls that the protocols became famous in 2004, when defender Serginho, from São Caetano, died on the pitch due to cardiac arrest. “Big clubs had the obligation to carry out tests not only to prevent injuries, but to avoid cases like this one”, he says.
Athletes who have cardiac arrest during the game can take some measures to return to perform at a high level. Eriksen, for example, has the implantable cardioverter-defibrillator (ICD), a medical device placed inside the body to treat serious arrhythmias.
It is important, according to Leal, to know what the warning signs are to identify if someone is suffering cardiac arrest and provide medical attention as soon as possible. “Time is muscle. The more time I waste, the more muscle dies,” she emphasizes.
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The post Damar Hamlin: understand why young athletes may have cardiac arrest first appeared on Metropolis.
