Sudden death in young athletes—can it be prevented?


Former Executive Editor, Harvard Health

In a recent seven-day span, three high-school athletes died suddenly while pursuing their sports.

  • March 3: Wes Leonard, a 16-year-old basketball star from Fennville, Michigan, collapsed after sinking the winning basket to clinch his team’s undefeated season.
  • March 8: 16-year-old Javaris Brinkley of Littleton, North Carolina, collapsed while playing basketball at a local church.
  • March 9: Sarah Landauer, a 17-year-old from Gainesville, Florida, collapsed during track and field drills at her school.

This may look like an epidemic, but it isn’t. Approximately 100 youth, high school, and collegeathletes die each year, more than half of them from a hidden cardiovascular problem. The recent string of deaths has renewed a hot debate among parents, coaches, and physicians: should the pre-sports checkup for competitive athletes include an electrocardiogram (ECG)?

On the pro side: Adding an ECG to the check-up will identify a few more athletes with potentially dangerous cardiac conditions. If a simple ECG can save lives, then it makes sense to do it.

On the con side: ECGs won’t detect all athletes at risk. In addition, they will mistakenly indicate that some perfectly healthy athletes have cardiac problems. The cost of adding ECGs to pre-sports check-ups is another barrier. As I write in the May 2010 Harvard Heart Letter, the American Heart Association estimates it would cost at least $2 billion a year.

Contradictory studies offer no clarity. A large study from Italy showed that adding ECGs saves lives, while a new one from Israel showed they make no difference.

No easy answers

As a parent of a basketball player and a dancer (one of my daughter’s tee-shirts says “If ballet was easier it would be called football,” and I believe it), I want every possible reassurance my children will be okay.

As a health writer, I know that we need to put our limited health care dollars to best use. Spending $2 billion on pre-sports ECGs to save 100 lives comes out to $20 million per life saved.

In the abstract, it’s easy to say that’s way too expensive, and we would be better putting this money into more cost-effective prevention and treatment strategies. But if one of those lives saved is one of my children, I’d pay it in a heartbeat.

And there’s the conundrum of modern (expensive) medicine—what’s good for the country and the health-care system isn’t always what’s best for the individual.


  1. John Leo

    Put in a next adolescent for the set of latest teen heart failure demise: Matthew Hammerdorfer perished enjoying rugby inside Ft Collins, Colorado. Although incorporating ECG screenings to your younger sportsmen actual tests generally seems to spot a lot of economic problem to be able to the expense of well being check-ups, the price tag on a great AED Computerized Outside Defibrillator) will be effortlessly cost-effective.


  2. Mike

    It is incredible how many people die from competitive sports, healthy people suffering from these sudden death cases it seams “ridiculous”… There’s still much we don’t know and hopefully future science and health combined will help many more sport players. It’s great that ECG came around to prevent certain sport players accidents.
    I just hope other preventive measures and solutions are rapidly found to immune these extreme sports death cases.

  3. Anonymous

    Thanks for this information, ECG should I think be included in any sport.I think the best way to do this is to educate them all about the right way in engaging sports without compromising the heart’s health and should be made aware of cardiovascular diseases in people their age.

  4. shawn

    stumbled across this ad while looking for baseball drills.Very informative blog here.Do you mind if I post some of your info on my baseball catcher site. Thanks

  5. F. D. Simon Mills

    We have come across 2 gentlemen that have passed away that have been very athletic and died suddenly. No real reason for this. The heart just stops. This is so tragic for the families. Maybe we should all just have a defibrillator built in like having a passport.
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  6. Popoy

    I was searching for Basketball drills review when I found this article about young athletes dying while playing their own sport. I think the best way to do this is to educate them all about the right way in engaging sports without compromising the heart’s health and should be made aware of cardiovascular diseases in people their age.
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  7. Shane

    This is a really touchy subject, as it is young peoples lives that we are talking about. However, someone must speak up, as you have and ask the question, are they really worth 20 million dollars per year? This money could be spent on other aspects of health, and possibly save thousands of lives. I know myself, as i am in the extreme sports industry, that this is far to common today. I have written a similar article that demonstartes how the sports industry has been affected by this sort of event.
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  8. Christi Johnson

    I have not heard of any deaths now that the school year has begun again, but I did hear that a local coach got into trouble for making his team work out (football) in extreme heat and gave them few breaks to cool down. I understand teaching student athletes to have stamina and to fight and to do better with each day/game….but there’s a point that you stop training and you’re just punishing. Great post and thanks for all you are doing!

  9. Ronald

    anyone ever think that maybe they athletes could be abusing illegal steroids or hgh? just point it out, i know that it may not always be the case but as you said over working the heart is never a great thing..

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  10. Shawn

    All children including high school students should be required to obtain medical clearance before engaging in any type of organized physical activity. The education of an athlete should be the next concern [URL removed by moderator].

  11. Jan

    Maybe once a year check with ECG equipment is enough. However, ECGs won’t detect all athletes at risk, as you wrote.

  12. Johnny Payne

    The study mentioned in the article was a very limited cohort and was a secondary , de-facto study. I would not hold that work in high regard. The Italian study was a large cohort, long-term effort that produced clear findings.

    These two studies are not comparable.


    ECG was a regular part in kids exams before joining any sport club, organisation in some countries, should be implemented anywhere where sport’s activity is greater than normal

  14. Professional Athletes David

    Great idea. ECG should I think be included in any sport. Because what is used the most part of a player is their heart. And we need to check if they are capable of doing this strenuous sport. We should take care of our players.

  15. Hanneman

    Amy man in my home town name X complaint pain in his chest just after finished playing football then his friends hurried bring him to hospital but only few minutes arrived Hospital the man X passed away. Was it an undetected heart attack ?

  16. tal jones

    Hi denise,
    What you wrote was very interesting,i have a friend that died in a sport,it was in a mma fight.

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  17. Jon Wade

    Always so sad to hear of such stories. Of course, it does not only affect the young. An old family friend died while refereeing a soccer match many years ago. Having trained first aider on hand may have saved him.

    What is most important is that people do not use this few sad cases to try to put young people off sport. If I had a dollar for every overweight person that ever said to me “the person that invented jogging died jogging” as their excuse for not exercising, well, I would have a fair few dollars.

  18. Laura Friend

    Thanks for wanting to learn more about sudden cardiac arrest in kids. I lost my 12 yr old daughter, Sarah Elizabeth, to an undiagnosed enlarged heart 6 years ago at a waterpark. We are still devastated and wish that her pediatrician would have even offered or educated us about the possibilities of hidden heart conditions. We would have paid for it. We also wish the waterpark used the aeds that they had. The lack of education and awareness caused my daughter’s death. It happens to an athlete every 3 days in this country. Sarah wasn’t an “athlete” but she was swimming and being athletic like most kids! Now we raise awareness in Texas and donate AEDs in Sarah’s memory.

    • Kimberly Black

      Hi Laura, My name is Kim. I am from a small town in Oklahoma. Here the school focus’ more on sports than the student’s education. Trust me, I graduated with honors in 1995 and I believe it to be only because I was a very good softball player. We took runner-up in state competition my senior year.
      Anyway, the reason I am messaging you is because I read your post on “Sudden death in young athletes-can it be prevented?” by P.J. Skerrett.
      I have a 13 year old son who was diagnosed with an ASD, aka-atrial septal defect, last summer. It was surgically repaired at St. Francis Children’s Cardiac Hospital last August. Recently I have heard of several young kids passing away due to the heat and undiagnosed heart conditions either at or just soon after participating in football practice. Most likely because schools are about to start and we all know football comes first, so they are geared up and hitting the field.
      I am going to attend the school board meeting at the end of the month to propose that the school invest in several AED’s to place in the gym’s, football field house, concession stands at the baseball and softball fields, and all the principles offices (there are 4). This would mean they would need to purchase 8-10 AED’s. Do you have any suggestions on how I may make my case with them? They are not going to just say ok to $30,000. But I will not give up at no. So if you have any suggestions to help I would greatly appreciate it.
      Sorry to hear about your daughter. Although I am glad to hear that you are doing so much to help save others. Thank you for your time.
      You can reach me at or P.O. Box 384 Panama, OK. 74951

  19. John

    I am a paramedic, and was recently on a call where a high school basketball player died due to an enlarged heart. I am reading all I can about it currently. Thanks for the information!

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  20. Denise Maier

    Add a fourth teen to the list of recent teenage cardiac deaths: Matthew Hammerdorfer died playing rugby in Fort Collins, Colorado. While adding ECG screenings to our young athletes physical exams appears to place too much financial burden to the cost of health check-ups, the price of an AED Automated External Defibrillator) is easily affordable. According to the Roanoke Daily Herald, Javaris Brinkley had a known heart condition. It was also reported that no one who witnessed his collapse started CPR nor retrieved the AED close by the scene. Whether a heart condition is known or not, having an AED applied to the victim within the first few minutes of Sudden Cardiac Arrest takes the chance of survival from less then 5% to up to 80%. So for all the parents of young basketball players, football players, rugby players, cheerleaders (that’s the catagory my daughter falls into), ballerinas, and all sports participants, make sure there are AEDs available and staff knows how to use them. I am an American Heart Association Administrator and Instructor. I post articles addressing AED awareness in our school systems, and answer questions people may have regarding AED use at It is estimated a young athlete collapses every three days. I am sure we all agree with the editor, Mr. Skerrett. When it involves our own child, no cost is too expensive to keep them safe. An AED is an affordable safety net and should be required at all athletic events.

    • Avatar
      P.J. Skerrett

      Denise — Thanks for the (sad) update. What a tragedy, especially with a witnessed collapse and a defibrillator nearby. Everyone involved with youth sports should know how to do CPR. By everyone I mean all coaches, players, and parents of players. I agree that an AED should be somewhere in the vicinity of a sporting event. We spend so much on equipping our athletes; an AED should be part of the package.

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