Four played basketball, two football, two lacrosse and one was a swimmer. All were male. The survivor played basketball.

"It's still surprising, given the young age," said Drezner of the fact that all but one died.

On further evaluation, the underlying cause of the sudden cardiac death was found to be hypertrophic cardiomyopathy (enlarged heart) in five students and heart attack in one. Two died from "commotio cordis" -- cardiac arrest caused by a blow or trauma occurring just as the heart is preparing to pump. This sudden trauma disrupts the heart's vital electrical system.

The use of AEDs outside of the hospital has helped save lives in recent years, experts say. The devices, found in casinos, airports, on airlines and in public buildings, have resulted in survival rates of 36 percent to 52 percent among the general population, Drezner noted.

Another expert, Dr. Mark Link, an associate professor of medicine at Tufts-New England Medical Center, Boston, agreed with Drezner. "You would have expected more of [the athletes] to survive. You would expect a 40 to 50 percent survival rate if an AED is applied within three minutes. And that is well-documented by other studies."

Link, who is also director of the Center for the Evaluation of Athletes at Tufts, called the results of the Seattle study "depressing and concerning." In his own research, published earlier this year in the journal Pediatrics, Link found that chest protectors worn by children while playing baseball or lacrosse didn't protect them from sudden death if they were hit in the chest with a ball and suffered commotio cordis.

While the findings are worrisome, Drezner and Link urged parents and athletes to put the findings in perspective and said officials should consider the study a reminder to focus on emergency plans. "It's an unusual event that a young athlete dies suddenly," Link said. About 75 to 150 young athletes per year experience sudden cardiac arrest in the United States, Drezner estimated, citing several studies.

"The emphasis is certainly not to be critical of the responders," Drezner said, noting that they all did a great job. "It could be that, in young athletes, the window [to save them] is short."

To reduce risk, young athletes should undergo a comprehensive history and physical before participating in sports, Drezner said. It should be done by a physician who is familiar with screening for athletic physicals. Any child or young adult with symptoms of heart problems, such as fainting while exercising or experiencing chest pain, should have a comprehensive cardiac exam, he said.

However, he acknowledged that, just as happens in the old, cardiac arrest can occur in the young with no warning. With that in mind, Drezner said, schools should review their plans for emergency protocols and be sure good procedures are in place.

Source: http://health.msn.com/centers

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