Ask the Pediatrician | Tweens

Tween's sudden death renews worry for parents of athletes

It’s horrible. Tragic. Unthinkable. And yet it happened. Again. This time the athlete who died was only 12. A sixth grader. Not even old enough to shave. How can his family and friends go on?

J. Cooper Salsberry was a multisport athlete who played goalie on his hockey team and was just getting his spring baseball season underway when his life was cut short. Cooper collapsed while running at a baseball practice and died a short time later. It’s still unclear what caused the middle schooler’s death but my office received several calls from worried parents about their children and whether they should undergo some sort of screening tests beyond the usual sports exam.

For now, the answer to that question is “No.” Studies have examined whether all student athletes should undergo screening tests like EKG or echocardiogram to look for very rare heart problems and the bottom line is that these tests are surprisingly not that sensitive when it comes to sudden cardiac death. Some organizations offer student athlete cardiac screening but to be honest, given the data we have about the likelihood of picking up a potentially lethal problem even in a child bound to go on to have sudden cardiac death, these screens provide a sense of peace for parents that may be ill founded.

We don’t know yet what young Cooper died of and even after autopsy we still may not know. Sudden death in athletes can occur due to seizures, brain aneurysms, as well as irregular heart rhythms, and heart defects. Even if a heart conduction problem is there, it often doesn’t occur at the time of screening and will be missed. Heart defects generally have some signs associated with them like lightheadedness while playing or near passing out during exercise that allow it to be discovered. Even if we did an echo at some point on every young athlete, heart problems can and do arise later and as such it is a snapshot of that moment in time and not a lifelong passing grade.

Even if we could screen all athletes yearly for cardiac issues, we would have so many false alarms that would exclude healthy kids from playing while the work up is completed that it would be onerous. Sudden death occurs in children who aren’t athletes too; should we screen everyone every year?

These are tough questions without clear answers when you are thinking about Cooper and his family and friends. It’s frustrating to realize that even with the advances of modern medicine we still cannot predict or prevent sudden death in young athletes. Sad too.

Dr. Molly O'Shea
Dr. Molly O'Shea is a board-certified pediatrician who cares for families in her practice Birmingham Pediatrics + Wellness Center. She will answer your questions on babies, children, adolescents and families and address common concerns.

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