Identifying Sudden Cardiac Arrest Risk in Adolescent Male Athletes

The purpose of the study was to determine the prevalence of sudden cardiac arrest (SCA) risk factors in high school (HS) athletes. Thirty-three male soccer players from a public HS in the southeastern United States (ages 14-17) self-reported survey data. Participants reported demographic, lifestyle, heart health, COVID-19 history, and symptoms indicative of SCA risk. An electrocardiogram (ECG) assessed heart rate (HR), rhythm, and electrical activity. Resting HR and blood pressure (BP) were measured with a BP monitor. The association between COVID-19 history, HR, and BP were calculated. Participants were divided into ECG groups (normal or abnormal). Independent t-tests assessed comparisons between groups to identify SCA risk. Over 50% of participants (n=17) reported experiencing shortness of breath (SOB) and 30% (n=10) reported chest pain. A history of chest pain was associated with abnormal ECGs (p<0.04). Thirteen (39.4%) participants reported a COVID-19 history. Of these, 5 presented with persisting symptoms, 2 with elevated HR, and 3 with elevated BP. Eleven (33.3%) participants had an abnormal ECG and of these eleven, 8 (72.7%) reported a positive COVID-19 history (p<0.01). The current American Heart Association suggested screening method is limited. An ECG should be used in preparticipation screenings (PPS) and return to participation (RTP) decisions for athletes with a COVID-19 history. Family cardiac history, chest pain during exercise, and an abnormal QRS interval should be used to identify SCA risk.