Bronny James, eldest son of LeBron James, suffered a cardiac arrest during basketball practice this week. He is 18 years old, and headed to USC as the top freshman recruit to the NCAA this season. A family spokesperson shared that Bronny is now out of the intensive care unit and in stable condition. Further details as to what may have caused the sudden cardiac arrest are not currently available.
While regular exercise is known to be one of the best means of protecting the heart in the short and long term, sudden cardiac events in healthy young athletes remain concerning, especially in recent years when several high-profile athletes have suffered acute events such as Bronny’s cardiac arrest. Some athletes have an undiagnosed pre-existing cardiac condition, but these are extraordinarily rare. A 2017 report published in the New England Journal of Medicine estimated that the incidence of cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete years, with a 43.8% survival after such events.
Pre-screening athletes for determining risk of sudden cardiac events is complex, and most medical associations do not recommend pre-screening electrocardiograms or echocardiograms in athletes with no known cardiac risk factors. Rare disorders such as a congenital heart condition, an abnormally enlarged heart, and family history of cardiac disease in young family members can be addressed on an individual basis, yet most athletes who suffer sudden cardiac have no history of such disorders in their own or their family’s health history.
Earlier this year, Buffalo Bills player Damar Hamlin suffered a cardiac arrest during a “Monday Night Football” game, and was rapidly resuscitated on the field and discharged from the hospital just a few weeks later, in good condition. Hamlin’s cardiac event was due to blunt trauma to the chest, leading to a rare event called commotio cordis, whereby the heart is struck at just the right (or wrong) time in just the right (or wrong) location in the chest to trigger a lethal irregular heart rhythm, or arrhythmia. Because of the immediate on-field response to Hamlin’s collapse, first responders were able to restart his heart by using a combination of CPR and electrical shock defibrillators.
Just last year, USC Freshman Vince Iwuchukwu suffered a cardiac arrest during summer practice, and was resuscitated by USC medical staff on site. He received immediate CPR and shock defibrillation, and returned to the basketball court six months later. Automated external defibrillators, or AED’s, can enable the responder to administer life-saving electrical shocks to restart a heart that has sustained an arrest. These devices are located in schools, airports, shopping malls, and many grocery stores.
With wearable health trackers now the norm, some studies have shown that these may be key in early detection of cardiac issues, including abnormal rhythms and even a heart attack. However, we are likely years away from having this technology be a fool-proof way to truly detect chronic or acute issues. That said, the potential for better and more accurate monitoring with wearables and smart watches is likely in our future.
According to early reports, Bronny is thankfully recovering from his sudden cardiac arrest, thanks to swift medical response by the USC medical staff on site. In addition, the fact that he is a young, healthy individual bodes very well for his recovery.
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