Chances are if you’ve been following the news, you’ve heard about Bronny James being rushed to the ICU earlier this week. On Monday, the eldest son of NBA superstar Lebron James suffered what is reported to be a cardiac arrest during an offseason college basketball workout for the USC Trojans.
What happened to Bronny was incredibly alarming. A young collegiate athlete in peak physical condition experiencing a sudden cardiac arrest in the middle of practice is extremely rare. Fortunately, from the news reports, it seems that he is in stable condition after being swiftly rushed to the hospital by paramedics. Given how renowned and accomplished his father is, it’s no surprise that Bronny’s cardiac arrest was instantly trending on social media. With the amount of misinformation disseminated online, I felt this was a great opportunity to provide more clarity on Bronny’s health scare from a cardiac and medical perspective.
Cardiac Arrest vs Heart Attack
The first and most critical distinction to make is differentiating the terms cardiac arrest and heart attack.
Cardiac arrest: This is when your heart spontaneously stops beating resulting in no blood flow to the rest of the body. Blood pumped from the heart carries oxygen that is vital to all of your organs and cells. Without oxygen, organ dysfunction occurs and cells can die instantly. A sudden cardiac arrest can become fatal within minutes. This would present as a sudden loss of consciousness, cessation of breathing, and absence of palpable pulses.
Heart attack: This occurs when there is a blockage in the arteries supplying blood to your heart. This results in ischemia, or a lack of blood supply, to a particular area of the heart impairing its ability to function. The heart usually continues to beat but may not be able to pump out as much blood to the body. A heart attack can typically present as severe chest pain, sweating, and pain radiating down the left arm/jaw.
It is a blessing that Bronny James is alive and medically stable, and all the healthcare workers who intervened in this cardiovascular emergency should be praised for their quick and proactive actions. Unfortunately, not all young athletes are as fortunate as Bronny. Sudden cardiac arrest is tragically the leading cause of death among young athletes. Why is that the case? No parent wants to deal with the risk of losing their child to something as innocuous and enriching as organized sports. Let’s take a further look.
The Various Causes of Cardiac Arrest in Young Adults
The leading cause of cardiac arrest amongst young athletes is a condition called Hypertrophic Cardiomyopathy. Hypertrophic Cardiomyopathy is a condition in which the walls of the heart are excessively thick leading to poor filling of blood in the heart chambers. Poor filling means that less blood is entering the chambers of the heart in the first place which therefore means less blood is being pumped out to the rest of the body. Famed Celtics basketball player Reggie Lewis died at the age of 27 in 1993 due to Hypertrophic Cardiomyopathy.
Another cause of cardiac arrest can be due to a genetic condition like Marfan's syndrome. Marfan's Syndrome is a connective tissue disorder that causes tissues and cartilage to be stretched more and overgrowth of bones making them longer than usual. People affected with this condition have elongated limbs, vision problems, and can die from cardiac abnormalities if blood pressures are consistently too high. Back in 2014, Baylor basketball star Isiah Austin was poised to enter the NBA draft when a routine health screen discovered a mutation in his genes. While this diagnosis forced him to retire from a career in basketball, as the increased cardiac activity would have been extremely risky, Austin was fortunate to have this condition discovered early.
It hasn’t even been a season since the NFL world held its breath when Damar Hamlin collapsed on the field. Hamlin suffered from a cardiovascular event called Commotio Cordis, which is a traumatic impact on the chest wall causing your heart to go into ventricular fibrillation and eventually cardiac arrest. Ventricular fibrillation is an arrhythmia (irregular heartbeat) that is life-threatening and requires immediate medical attention. While Bronny James did not play football and was less likely to sustain a direct impact on his chest wall, he could have very easily experienced ventricular fibrillation due to his aggressively elevated heart rate during practice. Other notable causes of cardiac arrest can be due to rare electrical disorders and channelopathies such as long QT syndrome, Wolff-Parkinson White (LaMarcus Aldridge was diagnosed with this), Brugadas syndrome, etc. Additionally, it is essential to highlight that a considerable proportion of cardiac arrest incidents occur without any identified cause or associated heart abnormality.
Treatment and Prognosis for Cardiac Arrest
Immediate and prompt medical attention is crucial when an athlete encounters a sudden cardiac arrest to ensure their life is saved. If an athlete collapses, becomes unresponsive, exhibits abnormal breathing, or there is no audible heartbeat, it is imperative to call 911 without delay and perform CPR. CPR, short for cardiopulmonary resuscitation, entails performing chest compressions that imitate the heart's natural rhythm, providing a temporary blood supply to the body until medical professionals reach the location. This vital technique plays a crucial role in maintaining circulation during emergencies. Previously, artificial ventilation (mouth-to-mouth resuscitation), was a core component of CPR practice. However, it is no longer necessary or recommended since it can divert critical seconds away from essential chest compressions. Once medical or trained professionals arrive, they will likely employ an AED (automated external defibrillator) to deliver a controlled electric shock to the person's heart, helping restore its rhythm and resume blood circulation without the need for continuous chest compressions.
This was the exact sequence of events that occurred in the situation of Damar Hamlin when the Buffalo Bills medical staff saved his life using CPR. The USC medical and athletic staff likely did the same for Bronny James, helping to save his life.
Data Behind Covid Vaccine and Cardiac Effects
Amidst Bronny's health scare, certain comments on social media and specific news outlets raise concerns about it being a potential side effect of the COVID-19 vaccine. However, a paper published in the NCBI on January 2023 sheds light on this issue, stating that the incidence rate (IR) of cardiac arrhythmia post-COVID-19 vaccination is rare, ranging from 1 to 76 per 10,000 cases (0.01% - 0.76%). Extensive research has consistently shown that the benefits of the COVID-19 vaccine far outweigh the risks of either the vaccine itself or the risks of contracting COVID-19 in the absence of vaccination.
While I cannot definitively comment on whether the COVID-19 vaccine played a role in Bronny’s cardiac arrest, from a medical perspective, it is crucial to note that this condition has been documented in young athletes for over 100 years, preceding the pandemic and the vaccine's availability. Thus, his cardiac arrest could more likely be attributed to various other causes or might remain unexplained, rather than solely blaming the COVID-19 vaccine. Hopefully, doctors can quickly ascribe a reason to this anomalous event. Regardless, the most important thing is that Bronny James is in stable condition.
Dr. Kishan Srikanth
Edited by Nithanth Ram
Excellent content! Thank you for writing about these complex topics in an easily digestible manner. Everyone ought to know more about cardiac arrest and it’s causes, especially given how common it is.