David Wilganowski, a 17-year old football star at James Earl Rudder High School in Bryan, Texas, was in the middle of a game when his heart stopped. In cardiac arrest, he staggered toward the sidelines and collapsed.
Fortunately for Wilganowski, the certified athletic trainers who staffed every game at the school jumped into action, performing CPR and restarting his heart with an automated external defibrillator, or AED. By the time paramedics arrived, his heart was pumping again.
He's one of the lucky ones. Though relatively rare, a cardiac event that strikes a young person at practice or play is often deadly. About 100 young people die every year playing organized sports, and cardiac arrest is the cause in half the cases, according to the National Athletic Trainers' Association (NATA).
Dr. Dominic Abrams, a cardiologist at Boston Children's Hospital, said cardiac conditions in young people typically fall into one of two categories.
The first, cardiomyopathies, involve some abnormality of the heart such as enlargement, thinning walls or scaring. The second type is caused by rhythm disturbances. Nothing appears wrong with the heart but it has a tendency to beat irregularly in some way.
In Wilganowski's case, he was diagnosed with a genetic condition known as Long Q-T syndrome. Characterized by rapid heart "quivers" instead of normal rhythm, the heart sometimes stops beating altogether.
Abrams said that at-risk children and young adults can experience a heart event any time but that exercise certainly increases the chances.
"Patients can be at home watching TV when it happens," he said. "But we know that symptoms might be exacerbated during sports because their adrenaline is pumping, causing the heart to beat faster."
High school players of hard driving sports like basketball, football and hockey are not the only ones at risk either -- though their stories are the ones that usually make the news. Abrams referenced a subtype of Long Q-T syndrome that's associated with swimming deaths.
"It's thought to be brought on by the 'diving reflex,' which triggers sudden changes of heart rate and may cause loss of consciousness -- an inherently dangerous occurrence in a pool," he said.
American Heart Association studies show that young black athletes have a greater incidence of cardiovascular death than whites. And a Dutch study in the Journal of American Cardiology found that 68 percent of cardiac arrest cases during sports play were boys.
To Screen or Not to Screen
As Laura Friend said she knows all too well, not every young person who dies from cardiac arrest is a boy or even a competitive athlete.
Her daughter Sarah was a typical active 12-year-old who played sports just for fun. Sarah was at a local water park near their home in North Richland Hills, Texas, taking a lifeguard training class when she lost consciousness.
Ironically, while the course taught CPR and the use of AEDs, Friend said neither was performed on her daughter. It took more than 24 minutes for the ambulance to arrive. She never regained consciousness.
"What was survivable turned into a nightmare," Friend said.
Since her daughter's death, Friend has become an advocate for AED placement and training in schools and says all children should be given "sports physicals," even if they don't participate in competitive sports.