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Cardiac issues among young athletes are rare, but there are precautions to take


Last week, LeBron James' son, Bronny James, suffered a cardiac arrest during basketball practice with the University of Southern California's basketball team. The 18-year-old joins the team as a freshman this fall. James was released a few days later, and his workup will be ongoing, according to a statement from the hospital. But some people online, such as Elon Musk, were quick to speculate, linking James' cardiac event to the COVID-19 vaccine. And even though doctors are saying this is misinformation, that message still circulates. Joining us now is Dr. Matthew Martinez. He's the director of sports cardiology at the Morristown Medical Center in New Jersey. Thanks for being with us.

MATTHEW MARTINEZ: Thanks for having me. And we're excited to talk about this important topic.

RASCOE: Elon Musk, without evidence, claims that Bronny James' cardiac arrest was caused by myocarditis, which can be a side effect of the COVID vaccine. But how common is that, actually?

MARTINEZ: So let's dig into it. So myocarditis is a known cause of cardiac arrest in young athletes. In general, sudden death in young athletes is uncommon, occurring somewhere between 1 in 50,000 and 1 in 100,000 athletes in the United States every single year. So myocarditis is on the list of potential complications. It was here before COVID. It will be here after COVID. But it is not one of the more common causes we think about with regards to sudden cardiac arrest in athletes in total.

RASCOE: Can you explain what myocarditis is? And even though you have - you can have cardiac arrest and not die, like, is that a difference? Because you're talking about sudden death, but Bronny James is still here, you know, thankfully.

MARTINEZ: Sure. So let's take a half step back. So often these terms get thrown around, and they're confusing. Sudden cardiac arrest or sudden cardiac death is when the heart is functioning fine ahead of time. There's no blockages. And you have a heartbeat one minute and no heartbeat the next. Your heart simply stops. Either the heart muscle is abnormal, there's an electrical change or there's something yet to be discovered inside your heart that falls into that sudden unexplained death category. Now, myocarditis is inflammation of the heart muscle, and that can come from viruses, and that can lead to the heart stopping. It can lead to the heart becoming weakened. And that is a known cardiac arrest risk in young athletes.

RASCOE: Is it true that Black male athletes are more likely to suffer from these issues than white athletes?

MARTINEZ: Absolutely right. There are some differences in who may be at risk. So men more than women. African American men are at the highest risk. And then there are some sports like football, soccer and basketball, which seem to have the highest risk amongst the sports where we see more cardiac events.

RASCOE: Some athletes at the collegiate level do undergo medical screenings. But are these screenings enough? And what pre-screenings should athletes go through to rule out underlying health problems that could lead to this sort of medical episode?

MARTINEZ: That's an important conversation. And I always think about the evaluations of an athlete from a cardiac standpoint really in three pieces. And the first is a pre-event assessment. So a good physical exam, a comprehensive history, knowing about who they are, what type of athlete they are, their family history and their own personal history goes into a discussion about what their potential risks may be. An electrocardiogram and an echocardiogram are part of the professional athlete assessments and are more and more common in collegiate and high school sports. But in no way are they perfect, and in no way are they going to eliminate risks in everyone. So it's a reminder that pre-assessments are important, but it doesn't eliminate the real benefit. And the real benefit of how we can all handle athletes, and I'm hoping this is a big takeaway from this, emergency action plans, hands-only CPR and the early use of an AED when indicated is the best way to improve the survival of our athletes throughout the United States. It's the chain of survival that we've seen more wins with in the last several years than in any other way we've done it.

RASCOE: What advice, then, do you have for young athletes and families who may have concerns, you know, seeing all of this in the news?

MARTINEZ: So my advice for everyone is to do the following. Anyone can be a first responder. It doesn't take long to understand how to do hands-only CPR. It doesn't take long to know how to deliver an AED quickly and how to use it. So if you're in a community, what you should be asking yourself is, can I deliver what those USC folks have done twice this year where they've practiced an emergency action plan, they know who's going to get the defibrillator, who's going to call 911, who's going to start CPR. They know the signs and symptoms and the features of what sudden cardiac arrest looks like in a young athlete. And then they act quickly. These are rare events, but when it happens, you've got to be prepared. I think that's the message.

RASCOE: That's Dr. Matthew Martinez, director of sports cardiology at the Morristown Medical Center. Thank you so much for speaking with us.

MARTINEZ: Thanks for having me. What a great conversation. And I really love that you're bringing this to the community. This is how we're going to improve the outcomes for athletes. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.
A Martínez
A Martínez is one of the hosts of Morning Edition and Up First. He came to NPR in 2021 and is based out of NPR West.