Sept. 15, 2006, was an exciting day for Matt Nader, an offensive tackle on his high school football team. His family cheered as his team battled its No. 1 rival.
Then, in an instant, Nader’s life changed. He collapsed, unconscious and with no pulse. His heart had stopped. His parents, both physicians, performed CPR until paramedics rushed him to a hospital.
Nader had sudden cardiac arrest (SCA). If his parents had not acted with urgency, he could have died within minutes.
Unlike a heart attack — in which blood flow to the heart is blocked — SCA happens when there are problems with the heart’s electrical system. The heart beats irregularly, then suddenly stops.
Nader’s SCA was caused by idiopathic ventricular fibrillation (IVF).
“ ‘Idiopathic’ means there was no reason you could have known you’re at risk,” said Nader, 27, of Austin, Texas. “ ‘Ventricular fibrillation’ means your heart is quivering like a bowl of Jell-O instead of pumping blood.”
The day after the game, doctors implanted a defibrillator in Nader’s chest. Nader, who considers himself a lucky guy, must avoid strenuous exertion to prevent another attack.
Nader’s knowledge of heart disease helped land him a job at St. Jude Medical Inc. in St. Paul, Minn. He sells cardiac rhythm management devices to cardiologists and coaches patients who use them.
Nader also is an advocate for SCA screening and treatment.
“In addition to coaches and student athletes, everyone should know what to do when they see someone have an (SCA) attack,” said Nader. “You never know when you’ll be the bystander when this happens.”
LEADING CAUSE OF DEATH
SCA is the leading cause of death among student athletes, according to a 2014 University of Washington study. But sources disagree about how many occur each year.
On this they agree: There are more SCDs among adults than children. “But when a child dies, it’s devastating,” said Dr. Mickey Eisenberg, author of “Resuscitate! How Your Community Can Improve Survival from Sudden Cardiac Arrest” and emergency medicine professor at the University of Washington in Seattle.
Most student athletes have healthy hearts. “But there’s a subset of kids who have silent-but-discoverable heart problems,” said Dr. Vinay Nadkarni, professor of anesthesiology and critical care at the University of Pennsylvania in Philadelphia. “They’re lurking, waiting for an incident to cause an SCA.”
The most common causes of SCDs among student athletes are hypertrophic cardiomyopathy (an abnormally thick heart muscle has trouble pumping blood), commotio cordis (a blow to the chest disrupts the heart rhythm) and coronary artery anomaly (a congenital abnormality of the heart causes it to stop), according to the American Heart Association. Nader’s IVF is an anomaly.
WHAT TO DO
Survival rates are higher when bystanders know the protocol:
Call 911. Put your phone on speaker mode so you can talk to the dispatcher while you help the victim.
Start CPR.
If there’s an Automated External Defibrillator (AED) on hand, use it immediately.
An AED is a lightweight, portable device that delivers an electrical shock to the heart. “It doesn’t jump-start the heart like car battery cables,” explained Mary Fran Hazinski, professor of nursing at Vanderbilt University School of Nursing. “It’s more like control/alt/delete. It silences the chaotic electrical activity so the heart can reboot with a normal rhythm (fibrillation).”
SCREENING STUDENTS
There is a growing network of organizations that screen students for conditions that make them SCD candidates. (For one in your area, visit www.screenacrossamerica.org.)
Many of these groups are led by parents of SCD victims, like Mary Beth Schewitz, of Lake Bluff, Ill. After her 20-year-old son, Max, died in 2005, she established the Max Schewitz Foundation. She will never see Max continue his career as a herpetologist, get married or have children, she said, but her “family” grows to include kids who are treated before they become victims.
The Schewitz Foundation has provided about 56,000 electrocardiograms (EKGs) and about 1,000 echocardiograms (ECHOs) to Chicago-area students. These screenings have identified about 1,300 students who required additional evaluation. Treatment ranges from medication for low-risk students to open-heart surgery for high-risk students. Many need implanted devices such as pacemakers or defibrillators.
Some teens balk because positive test results could force them to quit doing the sports they love, said Schewitz.
“I was angry,” said Konrad Mueller, 22, of Libertyville, Ill., after a 2008 EKG showed he had Long QT syndrome, a heart rhythm disorder that can cause SCD. “I had to quit my school sports. Now, I’m grateful; the test saved my life.”
Mueller takes beta blockers to stabilize his blood pressure and sees his cardiologist regularly for EKG and stress tests. “What happened to Max (Schewitz) could happen to me,” said Mueller, who is completing a yearlong fellowship with Illinois Gov. Bruce Rauner.
COULD BE HEREDITARY
Many of the conditions that trigger SCAs are hereditary, so siblings should be screened too. After Mueller tested positive, his sister learned she had the same condition. “Now our family has an AED, and it goes where we go,” said Mueller.
Many states now require teen athletes to be screened and residents to learn CPR. “Unfortunately, some states have the laws, but they aren’t funded,” said Nadkarni. Therefore, some places are better prepared than others.
“Seattle is exemplary,” said Hazinski. “It’s a city of rescuers. It has a ready population of people trained in CPR and excellent dispatchers who can walk you through it by phone.”
“Someday, we’ll look back and say, ‘Imagine, in 2016, every student athlete didn’t have an EKG and everyone didn’t know CPR,’” said Schewitz. “It’s like seat belts, bike helmets and Pap smears. They’re routine now, but it wasn’t always that way.”
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