Heart (Cardiac) Health

Heart health is important for all athletic participants, and there are several safeguards and measures in place to ensure the safety of all UIL athletes. Below you will find information about the Sudden Cardiac Arrest Awareness Form, rules related to Automated External Defibrillators and the required medical history form. All of these tools help protect student athletes. While the UIL does not require an ECG or EKG for all participants, any student may choose to have these test prior to athletic participation. 

The Sudden Cardiac Arrest Awareness Form must be signed by students and parents annually. This form reviews the symptoms and warning signs of Sudden Cardiac Arrest. There are various screening options available, which are also detailed in this form.

Automated External Defibrillators (AEDs) are required at all schools and athletic activities. All coaches, nurses, sponsors, band directors and student trainers are required to have a current CPR and AED certification. AEDs are available not only to the students, but also to any coach or spectator who may suffer a cardiac event while at school. 

The Medical History form required each year includes the 12-question heart screening recommended by the American Heart Association. If a student or parent answers "yes" to any of these questions, additional testing must be completed by a doctor before a student can participate.

Sudden Cardiac Death

Sudden cardiac death is an abrupt occurrence where the heart ceases to function and results in death within minutes.

Arnold L. Fenrich, M.D.

What is Sudden Cardiac Death?

• It is not a heart attack.
   
• It is usually due to a malfunction of the heart's electrical system that coordinates the heart muscle contraction to pump blood through the body. The lower chambers (ventricles) of the heart go into fibrillation (ventricular fibrillation) - a fast and disorganized contraction. The ventricles spasm or quiver and can no longer pump blood to the body. The heart cannot recover from ventricular fibrillation on its own.
   
• Sudden cardiac death in athletes is usually caused by a previously unsuspected heart disease or disorder.
   
• The occurrence of sudden cardiac death is thought to be in the range of 1 out of 100,000 to 1 out of 300,000 high school age athletes. So it is very rare.

What are the possible causes of Sudden Cardiac Death?

• Hypertrophic Cardiomyopathy - a condition where the muscle mass in the left ventricle "hypertrophies". The thickened heart muscle can block blood flow out of the heart and can increase the risk of ventricular fibrillation. In over half of the cases, this heart disorder is hereditary and is most common in young adults. This is the most common cause for sudden cardiac death in athletes in the United States.
   
• Coronary Artery Abnormalities - an abnormality of the blood vessels that supply blood into the heart muscle. This is present from birth, but can be silent for years until very vigorous exercise is performed. During exercise, blood flow to the heart muscle can be impaired and result in ventricular fibrillation.
   
• Commotio Cordis - a concussion of the heart that can occur when someone is hit in the chest in the area of the heart. Objects such as a baseball, softball, hockey puck, lacrosse ball, or even a fist can cause ventricular fibrillation upon striking the chest. These injuries are rare.
   
• Marfan Syndrome - an inherited abnormality of the connective tissue (ligaments and tendons) in the body. Often these people are tall and thin with long arms, legs, fingers and toes. The wall of the aorta, the main artery from the heart, can become weak and rupture, especially during exercise.
   
• Wolff-Parkinson-White Syndrome - an extra conduction fiber in the heart that can allow for rapid heart beat episodes and in some cases ventricular fibrillation can occur.
   
• Long QT Syndrome - an inherited abnormality of the heart's electrical system. Episodes of rapid heartbeat can occur in the bottom chambers of the heart (ventricles) and ventricular fibrillation can result.
   
• Recreational Drug Use - even someone with a completely normal heart can develop ventricular fibrillation and die suddenly due to drug use.

What are the Warning Signs to be aware of?

• Palpitations - feeling fast or skipped heart beats.
• Dizziness - feeling lightheaded.
• Chest pain or chest tightness with exercise.
• Shortness of breath.
• Syncope - fainting or passing out.

ANY of the above symptoms that occur while exercising is a warning sign for sudden cardiac death and warrants further evaluation before participating in any more exercise or sports.​