If you’re a parent of a young athlete, your calendar is probably packed with practice schedules, games and trips to the store for more snacks and sports gear. You might worry about sprained ankles and sore muscles or about making sure your kid stays hydrated. One risk many families don’t expect, though, is heart problems.
Because heart disease is often thought of as an adult issue, it might not cross your mind when your child heads out to practice. The truth is that children and teens can have serious heart issues too and, for some, intense physical activity like competitive sports can bring them to light.
Some heart conditions may be present from birth but don’t cause symptoms until later in life. Others can develop after an illness or go unnoticed for years. In rare but tragic cases, the first sign of a heart condition is a sudden collapse on the field.
Whether your child is starting a new season or playing sports year-round, knowing the potential risks is a powerful step in keeping them safe.
Why heart health matters in young athletes
Your child’s heart works harder during sports. It beats faster to send more oxygen to their muscles. For most kids, this is totally fine. But for some it can be risky, especially if they have an undiagnosed heart problem.
“Even healthy-looking children can have silent heart problems,” said Deepa Prasad, MD, a pediatric cardiologist with Banner Children’s. “That’s why parents and coaches need to know the signs and take them seriously.”
One of the most serious risks is sudden cardiac arrest or SCA. This is when the heart suddenly stops beating. It can happen during or after intense activity, like running or playing sports. “SCA can even happen without any warning during sleep,” Dr. Prasad said.
A child may suddenly collapse, stop breathing, lose their pulse or seem like they’re having a seizure. SCA is very dangerous and can lead to death if not treated right away.
Common heart conditions that increase the risk of SCA
1. Hypertrophic cardiomyopathy (HCM)
HCM is a condition in which the heart muscle becomes too thick. This can make it harder for the heart to pump blood and may cause irregular heartbeats. It’s one of the most common causes of SCA in kids and teens.
2. Arrhythmogenic right ventricular cardiomyopathy (ARVC)
ARVC is a rare inherited condition where the heart muscle in the right ventricle is replaced with fat or scar tissue. This can lead to life-threatening arrhythmias (irregular heartbeats), especially during exercise.
3. Congenital heart defects
Some children are born with heart problems that may not be noticed until they start playing sports. These might include holes in the heart, valve issues or abnormal blood vessels. Sometimes, these problems only appear when a child’s heart works hard during intense physical activity.
4. Commotio cordis
Commotio cordis is a rare cause of sudden cardiac arrest that happens when a child receives a blunt hit to the chest — often during sports like baseball, hockey or lacrosse — at a very specific moment in the heart’s rhythm.
“With commotio cordis, there’s no underlying heart disease,” Dr. Prasad said. “It results from a sudden blunt impact over the heart during a specific window in the cardiac cycle, disrupting the heart rhythm.”
Protective gear like chest protectors may help, but immediate CPR and an automated external defibrillator (AED) are the most effective lifesaving actions. “Every minute lost initiating these measures can decrease the survival rate,” Dr. Prasad said.
5. Myocarditis
Myocarditis is inflammation of the heart muscle. It can happen after viral infections, even the common cold or flu, and was a big concern during the COVID-19 pandemic. Although it’s not as common now, it’s still important to know the signs. Myocarditis can weaken the heart and increase the risk of arrhythmias during exercise.
Warning signs to watch out for
Sometimes, there are early signs that a child may have a heart condition. These symptoms can show up during or after exercise or even while your child is resting.
Watch for:
- Fainting or passing out during exercise
- Chest pain or tightness
- Heart racing or pounding
- Shortness of breath that seems unusual
- Feeling dizzy or lightheaded
- Extreme tiredness (not just from playing hard
- Unexplained sweating
- Seizure-like activity without a known cause
- A family history of sudden cardiac death or heart disease
“These symptoms can sometimes be brushed off as being out of shape or tired,” Dr. Prasad said. “But they could be the only sign that something serious is happening. Don’t assume it’s dehydration. Get it checked out.”
The importance of screenings
Before your child can play most school or club sports, they usually need a sports physical. However, these physicals don’t always check for heart problems. That’s why knowing your child’s personal and family history is important.
A check-up should include:
- A look at your child’s symptoms, especially when they exercise
- A detailed family history, including any unexplained deaths before age 50, fainting, seizures or known heart problems like cardiomyopathies or long QT syndrome
If your child’s provider has any concerns, they might recommend extra tests like:
- Electrocardiogram (ECG or EKG): This measures the heart’s electrical activity.
- Echocardiogram: An ultrasound that shows how the heart is working.
- Exercise stress test: This checks how the heart performs during exercise.
- Holter monitor: A small device that tracks heart rhythm for 24-48 hours.
- Cardiac MRI or CT: These tests give detailed images of the heart.
- Genetic testing: This might be recommended based on your family history.
“If there’s anything unusual in the personal or family history, or if the ECG shows something abnormal, your child should see a pediatric cardiologist for more tests,” Dr. Prasad said.
Returning to sports safely
If your child has symptoms or tests positive for a heart condition, they may need to take a break from sports. That can be hard, especially if they love being active. But safety comes first.
For conditions like myocarditis, cardiologists usually recommend resting from sports for several months while the heart heals. Kids may need to repeat tests to make sure the heart is back to normal before returning to full activity.
Even if your child hasn’t had symptoms, it’s smart to take it slow after a viral illness. Check with your child’s health care provider before they jump back into practice or games.
What you can do as a parent
- Schedule a pre-participation physical: Ask if your child should have an ECG or other heart screening.
- Learn CPR and how to use an AED: Many schools and sports facilities have AEDs. Knowing how to use one could save a life.
- Watch for symptoms: Know the warning signs and don’t ignore them.
- Ask about your family history: Share any heart issues with your child’s health care provider.
- Talk to coaches and schools: Make sure your child’s team has a plan for emergencies and access to an AED.
Takeaway
Sports can do amazing things for kids. They build confidence, teamwork and lifelong exercise habits. But keeping your young athlete safe means paying attention to what’s happening inside their body, too.
By staying alert, asking the right questions and working with your child’s health care team, you can help ensure their heart is just as strong as their love for the game. Schedule an appointment with your child’s provider or a Banner Health specialist.
