Hard blow to the chest can cause sudden cardiac death


Dr. Jeff Hersh

Q:  Can getting a sharp hit in the chest cause a heart attack in a young, healthy, athletic teenager?

A:  The heart attack we normally think of is from a blockage of the arteries that bring blood (carrying oxygen and nutrition) to the muscles of the heart, typically from atherosclerotic disease. This can impair the heart’s ability to pump blood, as well as cause the electrical system that synchronizes the heartbeat to malfunction (arrhythmia).  These can lead to sudden cardiac death (SCD). 

But people under age 35 rarely have severe atherosclerotic disease; hence, this kind of a heart attack is unusual in this age group. However, there are conditions that can cause SCD even in young healthy athletes, typically by causing a lethal arrhythmia. 

Dr. Jeff Hersh

SCD affects less than than 10 per million young athletes annually. More than 80% of these are actually due to an undiagnosed underlying heart problem. For example, in young athletes, hypertrophic cardiomyopathy (where the heart muscle is abnormally thick) accounts for 20% to 50% of SCD events; abnormal development of the coronary arteries for 10% to 20%; myocarditis (inflammation of the heart muscles, usually due to infections including certain viral infections) for 5% to 25%; and other conditions (including inherited conditions which affect the heart’s electrical system) for the rest.


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