Cases of sudden cardiac death in teenagers can be scary stories to hear on the news. These young adults are typically healthy and have no indication of heart-related problems. In many cases, the athletes received standard sports physicals. Is this something parents with athletic children should be concerned about?

Dr. Ryan Jones, a cardiologist in the Heart Institute at Le Bonheur Children's, says not necessarily. Undergoing an echocardiogram (an ultrasound of the heart) prior to playing is not practical for every competitive athlete. The single most important risk factor is a family history of sudden cardiac death.

“Sudden cardiac death is noted more in athletes, but this is more from the fact that these stories make the news. Sudden cardiac death is also seen in drownings and single car accidents; however, it is harder to prove what the causes of these deaths are,” Jones said.

According to the American Academy of Pediatrics, athletes most at risk are African American males. These deaths are extremely rare: 1 in every 400,000 athletes.

With the increased presence of automated external defibrillators (AEDs) in schools and in public settings, more young athletes are surviving sudden cardiac death. AEDs are not recommended for use on children less than a 1 year old.

However, there are some signs that a young athlete’s heart might need to be checked out. Those signs include:
- Fainting or nearly fainting
- Chest pain while exercising
- Diagnosed heart murmur

Talk to your child’s pediatrician if you are concerned about your young athlete.

Jenny Shelton, MSW, CCLS and Child Life Manager at Le Bonheur Children’s Hospital shares her own personal experiences in talking to children about death. This is good advice to follow for any parent struggling with this issue.

“I though I would tackle the difficult subject of talking with children about death.  I must quote my three year-old nephew Thomas, who randomly brought up death in our last phone conversation about people we love: “Aunt Jen Jen, one day we will all die, right? But not right now - maybe in a little while.”

As much as we would like to ignore the subject, we know that every living thing has a lifetime.  I think one of the hardest conversations parents have with their children is telling them that someone special has died.  As a Certified Child Life Specialist in the pediatric intensive care unit at Le Bonheur Children’s Hospital, my role is to help parents find the appropriate words when talking to their children about someone dying.  The first thing I educate parents on is how children understand death at different ages.  Children under the age of five have difficulty understanding that death is irreversible and need to hear concrete statements using the words “died” or “dead” in order to master this concept.  Children do not fully understand the concept of death until about the age of nine or ten.

I also encourage parents to be honest and provide simplistic explanations about how the person died.  By having explanations children are able to better understand the situation surrounding the death versus using their imaginations to fill in the blanks.  When someone special has died this is a great time to talk with children about feelings and how to express those feelings in a positive way.  Allow your child to see you become emotional. This is an important learning opportunity for children because people learn to express their emotions through modeling those around them. 

I always encourage parents to be available for children as they grieve the death of someone special. One way to do this is by providing support and answering questions that come up in the process.  Children are very intuitive and come up with some of the most inquisitive questions about death, so be prepared and know that you will not have all of the answers.  Finally, grief is not something you get over, it is something you journey through. This is true even for children.

Things to Remember:

Be familiar with your child’s understanding of death
Give honest and simplistic explanations
Talk about feelings
Model positive ways to express grief
Be available for support and questions

I love the book “Lifetimes”.  I would stress that everything big and small has its own lifetime. Some lifetimes are short (day/week) and some are long (many years).  I also like for young children “When Dinosaurs Die".  The book answers the question, what does alive mean.  The content enforces that every single life has a beginning or a time to be alive and then an ending or death. 
When I talk with children we talk about how death is a part of life and everything will die one day.  It’s important to start this conversation at a young age. Children need to understand life and death and feel comfortable and safe talking about it.”