Every year, there are cases of sudden cardiac arrest and sometimes death, even among the fittest athletes.
While heart attacks on the court or playing field are fairly uncommon, they are still worth learning about — especially if you or someone you love has a history of heart conditions.
This article examines why some athletes have heart attacks, the rate of death from these cardiac events, how rare these cases are, and whether COVID-19 and subsequent vaccines are linked in any way to these deaths.
Why do athletes die of heart attacks?
Sudden cardiac arrest in athletes during and after athletic competition can occur. But it’s very uncommon.
Although exercise is incredibly beneficial for most people, there are athletes with preexisting cardiac conditions. If these athletes unknowingly push the boundaries of physical activity too far, it can be deadly.
A 2018 reviewTrusted Source determined that sports-related deaths are majorly due to coronary artery disease in adults and cardiomyopathy or arrhythmia in youths.
Other heart conditions, like myocarditis, can contribute to sudden cardiac death, too, but these do not occur suddenly. Generally, someone with myocarditis would likely feel sick and not participate in the sport.
Medical care is available at most athletic events in case anything happens. Bystanders trained in CPR are often invaluable as well, since they may be closest to a player who has collapsed on the field or court.
What is the risk of sudden cardiac death in young athletes?
Sudden deaths, even among younger athletes, are extremely rare. Getting the exact rate of occurrence has been difficult, though. Inconsistent data collection methods and lack of consistency in research methods have made the prevalence hard to determine.
Research suggests the likelihood of sudden cardiac death (SCD) in high school athletes is between 1 in 50,000 to 1 in 80,000. The risk is higher for male athletes. For college-aged players, the risk is estimated at 1 in 13,426, with a higher rate for male college basketball players.
Researchers in a 2018 study examined cases of sudden cardiac deaths among athletes with a mean age of 16 years. The rate was 6.8 deaths in 100,000 people per year, which is a rate of 0.0068%, or less than half a percent.
Even though the risk and prevalence of SCD are relatively low, it’s always good to take preventive measures.
Currently, the accepted protocol for pre-participation screening is a health history and physical examination, but many European agencies feel strongly that an electrocardiogram (EKG) screening should also be performed on young competitive athletes.
Advocates for the pre-participation EKG screening cite that 60%Trusted Source of conditions that may lead to sudden cardiac death are detectable with an EKG.
How has COVID-19 impacted how many athletes die of heart attacks?
The coronavirus that causes COVID-19 has affected athlete deaths, but the exact numbers are unknown at this time due to co-morbidity factors.
It’s known that getting COVID-19 increases the risk of developing myocarditis. This condition can lead to heart attack as well as add inflammation to the body, which could increase any preexisting issues.
Myocarditis is a leading cause of sudden cardiac death in young athletes.
A 2021 observational study involving 1,597 athletes who had COVID-19 found that 37 of them (2.3%Trusted Source) had diagnosable myocarditis and possible myocarditis.
A 2022 study found this rate to be higher — 4%Trusted Source — for athletes who underwent cardiac magnetic resonance (CMR) testing.
Knowing that COVID-19 increases the risk of myocarditis and other cardiac conditions, the American College of Cardiology recommends cardiac screening for all athletes who have cardiopulmonary symptoms before they return to play.
Does the COVID-19 vaccine put athletes at risk of heart attack?
There is no definitive proof that COVID-19 vaccines put athletes at higher risk of heart attack. There may be a very slight increase in the risk of myocarditis post-vaccination, but it is very small.
Researchers in a 2021 studyTrusted Source investigated the association between vaccination and myocarditis among 4,931,775 people who received the vaccine.
They found that on average, there were 5.7 events of myocarditis or myopericarditis per 100,000 vaccinated people. That is 0.0057 of a percent.
Researchers determined that while there may be an association, the risk is quite low.
What are the symptoms and risk factors of sudden cardiac arrest during athletics?
Warning symptoms of sudden cardiac arrest include abnormal chest discomfort or shortness of breath during or within the hour after exercise.
A family history of cardiovascular disease or sudden death is also a risk factor a doctor should look at.
A 2019 retrospective study found that 29%Trusted Source of athletes had symptoms of heart disease before cardiac arrest.
What to know to prevent sudden cardiac death in athletics
Exercise helps prevent heart disease, but intense, longer bouts of exercise can raise the risk of sudden cardiac events. Athletes, by nature, try to push their physical limits, getting faster, stronger, and more skilled over time. So how much is too much?
In general, the positives of exercise outweigh the risks.
Researchers found that the instantaneous risk of a catastrophic event for people with heart disease is no longer significant for people who participate in more than 2 hours of exercise per weekTrusted Source. Adaptations from that exercise actually help protect the heart.
Prevention isn’t so much about stopping exercise as it is about screening for underlying heart conditions. If you are concerned about the risks of sudden cardiac death, ask yourself the following questions:
- Immediately after or during exercise, have you experienced unexpected shortness of breath, felt dizzy or faint, or noticed chest pain?
- Did any of your close relatives die suddenly from a heart attack or have cardiac disease before age 60?
If you want to investigate further, your doctor may recommend an EKG, which could add more data to support the use of medical intervention if needed.
With the immediate use of an automatic external defibrillator (AED), one 2019 study found there’s an 89% chance of survival for high school athletes following sudden cardiac arrest.
It’s vital that whenever you are exercising, there is medical equipment nearby to help reduce the risk of injury or death.
It’s important to remember that even though many athletes are “fit” and practice physical exercise, that does not mean they are healthy.
While fitness increases health, it does not ensure it. Other factors are extremely important, too, like proper nutrition, sleep, and recovery.
If you neglect your health, you will be at a much greater risk of sudden cardiac death.
The bottom line
If you’re an athlete concerned about the risk of a heart attack, you may want to look at your family history or talk with a doctor. The risk is quite low, but it is present. Getting a health screening can help you figure out next steps, if needed.
Make sure there is proper medical equipment available wherever you exercise or compete. Having medical assistance accessible can reduce the risk of death if you do experience cardiac arrest during play.
Most of all, take care of your health and body so you can enjoy your chosen sport for years to come.
