Sudden Cardiac Arrest: What Are The Signs Of This Hidden Killer Of Student Athletes?

On February 05, 2022, Preston Blair Settles of Newton, Massachusetts collapsed while playing in a high school basketball game for Brooks School in North Andover.

The 15-year-old died on February 27, after going into cardiac arrest at Boston Children's Hospital, according to a statement by his family.

Brooks Head of School said they are devastated by the loss. AP "Teen dies weeks after collapsing during basketball game" (Mar. 01, 2022).

Commentary and Checklist

According to the CDC, sudden cardiac arrest occurs when the heart suddenly stops beating, resulting in no blood flow to the brain and other vital organs. Sudden cardiac arrest typically strikes without warning, and unless effective emergency steps are taken immediately, serious disability or death will occur, just as it did to the athlete in the source article.

The risk is not rare. According to, “every two to three days in the U.S., a young athlete dies as the result of sudden cardiac arrest. In fact, sudden cardiac arrest is the number one cause of sudden death in exercising young athletes.”

Sudden cardiac arrest in young athletes is usually caused by a structural or electrical abnormality of the heart. Most of these abnormalities are congenital, but remain undiagnosed and may be unknown to the athlete. For individuals with an abnormal heart condition, exercise can be a trigger for sudden cardiac arrest. In some cases, a hard blow to the chest, like a baseball or hockey puck, or from contact with another player, can trigger sudden cardiac arrest.

What can schools do to help prevent tragic heart-related outcomes:

  • Although in most cases, sudden cardiac arrest strikes young student athletes without warning, school personnel should know some warning signs than may indicate a student athlete may have a heart condition that puts them at risk. Signs include:
    • Fainting or passing out during exercise
    • Chest pain with exercise
    • Excessive shortness of breath with exercise
    • Palpitations (heart racing) for no reason
    • Unexplained seizures
  • Require all student athletes to undergo a physical exam and to provide a comprehensive medical history before participating in sports.
  • Include a screening electrocardiogram (EKG) to the standard pre-participation physical evaluation.
  • Make sure medical personnel are onsite during practices and games.
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