Youth Sports

[Guest guest]

The article may be of interest to some youth coaches.

Ralph Giarnella MD

Southington, CT

Blow to chest can be fatal in child athletes, study

finds

CHICAGO, Illinois (Reuters) -- Children who play

hockey, football, lacrosse or baseball risk sudden

death from a hard blow to the chest even if they are

clad in protective gear, researchers said Monday.

Commercially available equipment may not adequately

protect young athletes if the chest is hit in a manner

that triggers an irregular heartbeat called

ventricular fibrillation, according to a study

presented at the annual American Heart Association

meeting in Chicago.

" If the blow occurs directly over the heart at a

particular time in the heart's cycle, the results can

be catastrophic, " said the report's lead author, Dr.

Barry Maron, director of the Hypertrophic

Cardiomyopathy Center at the Minneapolis Heart

Institute Foundation.

The heart's electrical activity becomes disordered and

its lower chambers contract in a rapid, unsynchronized

way, allowing little or no blood to be pumped.

Collapse and sudden death can follow unless immediate

medical help is provided.

Such a rare but tragic blow can come from a ball, bat,

hockey stick, puck or hard contact with another

person, according to the study.

Of the 182 cases of ventricular fibrillation tracked

by Maron since 1995, 47 percent occurred during

practice or competition in organized sports.

Thirty-nine percent of the children suffered fatal

chest blows despite the presence of protective

equipment. Their average age was 15 years.

The remaining 53 percent occurred during recreational

sports or normal activities around the home.

Among the athletes were 14 hockey players, 10 football

players, six lacrosse players and three baseball

catchers. In 23 of the deaths, padding did not cover

the chest at the time of the blows, and 10 deaths

occurred when projectiles directly struck the chest

protector.

The athletes wore standard, commercially available

chest barriers made of polymer foam covered by fabric

or a hard shell.

Further research conducted at the New England Medical

Center and Tufts University School of Medicine in

Boston, Massachusetts, found ventricular fibrillation

could be caused by a baseball moving 30 mph, but only

if impact occurred directly over the heart during a

20-millisecond window when the lower heart chambers

are relaxed.

The findings indicate a need for better chest

protection to make the athletic field safer for young

participants, Maron said.

Those involved with youth sports also must be taught

to recognize when a child has suffered the potentially

deadly heart rhythm -- known as commotio cordis -- so

that prompt resuscitation and defibrillation can

occur, he said.

" Hopefully, these data will represent a stimulus for

developing a truly effective chest barrier that will

be absolutely protective against the risk of these

commotio cordis catastrophes, " he said.