An apparently healthy high school cheerleader who died after collapsing during a football game this past weekend likely experienced sudden cardiac arrest, a rare occurrence that has again raised questions about the value of widespread screening.
Bystanders at Friday night's game briefly revived Angela Gettis, 16, of George Washington Preparatory High School in Los Angeles, using CPR, but she was pronounced dead at a local hospital after her heart stopped.
Gettis had no known health problems; her family is awaiting results of an autopsy to learn how her life ended so unexpectedly. A member of the Junior Reserve Officers Training Corps, Gettis had planned to major in forensic science in college.
Her death comes on the heels of sudden cardiac deaths among a half-dozen brawny high school football players in Texas, Arkansas, Georgia, South Carolina and Florida as they trained in the suffocating summer heat. The boys had several things in common, including having heavy-set physiques and collapsing early in the practice season, a likely result of pushing themselves when they weren't accustomed to the exertion.
Cheerleaders can be similarly stricken. On April 5, a 16-year-old girl collapsed from sudden cardiac arrest during cheerleading tryouts at North Hunterdon High School in New Jersey. Quick-thinking coaches and parents, who had been trained in CPR and use of automatic external defibrillators, sprang to action and saved her life.
However, in many cases, youngsters don't survive these episodes. Janet Zilinski, an 11-year-old New Jersey girl, died from sudden cardiac arrest after cheerleading practice on Aug. 10, 2006. Her parents, Jim and Karen Zilinski, created the Janet Zilinski Memorial Fund, which is pressing for a New Jersey law requiring AEDs at all public and private schools and sports fields and mandating that schools and sports camps have trained responders as well as emergency action plans.
"The Janet Fund is dedicated to preventing sudden cardiac death in New Jersey's youth through awareness, legislation, AED placement and training. It is our mission to make Automatic External Defibrillators (AEDs) available in every school in NJ and make them commonplace on playing fields," the fund's website says.
Sudden cardiac deaths remain relatively rare, with an estimated one in 100,000 to three in 100,000 young U.S. athletes succumbing annually, said Dr. Kathleen Maginot, a pediatric cardiologist at the University of Wisconsin in Madison. The incidence could be as rare as 1 in 1 million among children from ages 1 to 18, said Dr. Ian Law, a specialist in inherited heart rhythm disorders at the University of Iowa in Iowa City.
Maginot and Law said the No. 1 condition leading to the youngsters' deaths is hypertrophic cardiomyopathy, a congenital problem in which the heart becomes abnormally thickened. Second are abnormalities that impede blood flow through the arteries (not to be confused with artery-clogging accumulations of plaque), Law said.
Other conditions that can set the stage for sudden cardiac death include inherited arrhythmias, in which the heart beats erratically; infection of the heart muscle called viral myocarditis; other heart enlargements that weaken the heart; and inherited heart defects, including those that have been surgically repaired, Maginot said.