PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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Kids Play Sports with HEART!

Kids’ basketball season is upon us, where nailbiting final scores of 18-14 can be seen everywhere. (ahahahahahahaha- I couldn’t help myself!)  We all might giggle a bit about the tremendous emerging skill level of the under-4-feet crowd but whenever I’m a spectator at a kids’ basketball game, my own pulse increases NOT at the thought that nary a basket shall be made, but rather at the notion of sudden heart problems during exercise.  Let’s call it out a little.  I’ll share a tiny window into my thought chain so my own vital signs can normalize. I’ll be a love and spread the burden of these perseverating thoughts around a bit.  You’re welcome.

via GIPHY

#1. In the stadium.

The first thing that always invades my brain space is the story of that University of Maryland basketball player, Len Bias, who died in 1986 of a cardiac arrhythmia (abnormal heart rhythm) (see above).  That was awful indeed, and his arrhythmia was drug induced. While thankfully that’s not usually our primary concern in the pediatric age group, it still needs to be on the radar.  Crazy fluke cardiac arrhythmias of other types can occur during exercise, and while this shouldn’t prevent our kids from participating in vigorous athletics we do need to be aware of them.  Can’t really prevent an arrhythmia if it’s never been diagnosed, but if someone PASSES OUT WHILE RUNNING on the court or field you can be sure that’s one thing I want to rule OUT before that player returns to playing.

#2. On the court, the squeak of shoes on the floor.

Sudden collapse during exercise can also be caused by weird heart plumbing, also known by its jazzy name “anomalous cardiac anatomy.”  Sometimes the artery that supplies oxygen to the heart muscle to help it pump is hooked up incorrectly, and this causes what is effectively a heart attack when oxygen demand increases during exercise.  This is sadly a cause of sudden cardiac death and is often only diagnosed on autopsy.  The upside?—it’s rare. Again, in most situations it’s nothing we can prevent per se but our red flags should be up if a kid complains of CHEST PAIN DURING EXERCISE.  If that’s the case, the child should sit out immediately and not participate in any vigorous physical activity until cleared by a physician, most likely a pediatric cardiologist.

So here’s the drill:

if someone passes out or complains of chest pain during exercise they must stop immediately and be evaluated for the cause, including potential heart causes.  We can’t budge on this one, even if the player feels ok after a few minutes.  No physical activity until cleared by a physician.  Sometimes it just means getting an ECG or a chest xray and a physical exam, but that drill’s gotta get run through.

#3. Free throw.

Winter indoor sports seem hot and intense.  I’m not trying to say that outdoor sports aren’t; it just feels like indoor sports arenas have a stifling environment.  This of course makes me start down the path of who’s going to be dehydrated and over heat, or who didn’t have breakfast and is going to drop their blood sugar and feel faint.  I’m a real good time, don’t you think?  My message here—make sure your child has eaten a bit and is well hydrated before they play.  This one we CAN prevent, and it’s fairly simple.

 

Well, I think that’s enough sharing of sunshine for today, n’est-ce pas?  It makes me feel THAT much better that now, it won’t just be me watching out for all this stuff at kids’ sports events this winter.  And please… let me know if you witness a high scoring game of 26-23.  (!!!)

 

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