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Sudden Cardiac Death

What is it?

Sudden cardiac death in young athletes is nontraumatic, nonviolent, and unexpected. An athlete actually appears healthy within 6 hours before death. Most often, death is caused by a heart (cardiac) problem.

How often does it happen?

About 5 million youth participate in competitive sports each year. Chances of a teen dying from heart failure while playing sports is less than 1 in 250,000. Each year, approximately 10 to 13 such cases are reported in the United States. In comparison, about 15,000 teens die each year in motor vehicle crashes.

For reasons unknown, sudden cardiac death appears to be more common in boys, African-Americans, and football and basketball players. This may be because more athletes participate in these sports. Most deaths occur between 3 PM and 9 PM - during or immediately after training or competition.

What causes this?

Most young athletes who die unexpectedly from heart disease while participating in sports were not known to have heart disease. Most sudden cardiac deaths in athletes younger than 35 years are due to conditions that may be inherited or conditions that the athlete had since birth. Unfortunately, some heart problems that can cause death during sports training and competition are not likely to be detected during sports physicals or routine exams.

Screening Evaluations

Before participating in any sports, young athletes should have a complete physical exam that includes a detailed personal and family history of any heart conditions. Most children and teens who experience heart symptoms during physical activity will not appear to have heart disease during an exam, so more tests may be needed.

Athletic screening (sports physicals) should be done by a health care provider with the training, medical skills, and background to obtain a detailed family history of heart disease, perform a physical exam, and recognize heart disease. Screening evaluations should include a complete medical history and physical exam, including blood pressure measurements.

Parents Should Complete the Medical History Forms with their Child

Young athletes may be at greater risk and need further evaluation and tests if there is:

  1. A history of chest pain, dizziness, fainting, or abnormal shortness of breath or fatigue during exercise.
  2. Unexpected sudden death of a family member at a young age. (This could mean there is a possibility of inherited heart disease.)
  3. A history of abnormal heartbeat or heart murmur (most murmurs are harmless).
  4. Heart and/or eye problems experienced by an athlete who is unusually tall, especially if being tall is not common in other family members.

Electrocardiography (EKGs) and echocardiography (echos) are not recommended as part of regular screening of athletes. This is because a heart problem is found very rarely.


Most young athletes with heart conditions can participate in most, if not all, physical activities. Deciding whether to participate in physical activities is an individual choice. It is the main responsibility of health care providers to evaluate each individual heart problem and set individual limits of physical activity with appropriate consultation with a cardiologist.

Last Updated
Sports Shorts (Copyright © 2002 American Academy of Pediatrics) Conceptual design by the Ohio Chapter, American Academy of Pediatrics
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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