Scott Webb: Welcome to BayCare HealthChat. I'm Scott Webb. And today I'm joined by pediatric cardiologist, Dr. Kelvin Lau. He's here to discuss cardiac issues in student athletes and what we can do to help.

Doctor, it's nice to have you here today. We're gonna talk about cardiac issues in student athletes and I have a student athlete. My daughter is a basketball player. She'll be playing in college next year, so I'm an interested party, I'm sure listeners are as well. Let's talk this through then, like what is sudden cardiac arrest and how often does it occur in children and adolescents?

Dr. Kelvin C. Lau: Sudden cardiac arrest is a leading cause of sports-related death. It's not the same as, you know, heart attacks as people kind of know it. When we think of a heart attack, we think of blockage of the artery supplying oxygen to the heart. When we talk about sudden cardiac arrest, especially in this context, we're talking about usually an electrical issue where the heart suddenly goes extremely fast. It's unable to supply blood and oxygen to itself and to vital organs, especially your brain, and that could result in someone passing away. And this is, fortunately not terribly common, but it still affects about 10,000 people a year under the age of 25. And there are at least 350,000 cardiac arrests occurring outside the hospital each year.

So, it does happen often enough that I think a lot of people know someone who knows someone who this has happened to.

Scott Webb: So, Doctor, it makes me wonder then, why are student athletes more susceptible? Is it just they're just going at it so hard and so fast and it's just asking a lot of their hearts?

Dr. Kelvin C. Lau: So, there are a number of different causes for sudden cardiac arrest, but many of them actually are induced by stress and exercise is obviously a very good way to stress your body out. Oftentimes exercise is a good thing. It benefits your body, but when you have certain conditions, it does increase your risk that the arrhythmias that we worry about, the abnormally fast heart rhythms that can make perfusing your brain and your heart difficult are more likely to happen when you're exercising.

Scott Webb: Yeah, obviously, exercising, you know, is the culprit there. And of course we want our student athletes - we want all of us to get more exercise. But there are some concerns. And along those lines then, Doctor, there things that we can do to prevent sudden cardiac arrest in student athletes?

Dr. Kelvin C. Lau: I think it is very critical that student athletes meet with their doctors regularly. Tell them of any potential symptoms. For instance, if they are experiencing dizziness, if they're experiencing chest pain when they're exercising, if their heart is racing abnormally even long after they're exercising.

I think that athletes and the students need to be very truthful with themselves and also to those around them, especially with their doctors and their health providers.

But I think one of the most important things that we are trying to do now is to, in addition to the annual exam and the history that we get from student athletes, is to also perform an EKG at least once a year or once every other year to try to increase our ability to detect some of these conditions that we worry about that could cause sudden cardiac arrest.

Scott Webb: Right. Yeah. And you mentioned EKG there. What's an ECG And what does it reveal?

Dr. Kelvin C. Lau: So, ECG, EKG, electrocardiogram is basically a way of getting a look at your heart, relatively easily and quickly. So, what it does is basically collects the electrical signals coming from your heart. And through these electrical signals, we can kind of get a sense of whether your heart may be enlarged, it may be thickened, maybe a little stressed out, or maybe even have an abnormal heart rate or abnormal rhythm. So, it kind of gives us a lot of clues in a really short and easy test.

Scott Webb: Yeah, short and easy and can reveal so much. And you know, from the perspective of parents, Doctor, what can we do? You mentioned earlier about athletes being sort of honest with themselves, honest with their coaches and doctors. What can we do as parents to minimize the risk of undiagnosed cardiac disease?

Dr. Kelvin C. Lau: I think that for parents, I think we really have to be mindful of when our children, our students, are pushing themselves beyond their limits, to make sure that they get rest and kind of check in on them as to whether they're having any problems when they  start acting funny, performing differently, and of certainly making sure that they go for those visits to their health care providers.

Scott Webb: Yeah, the annual visits, EKG, ECG, all the tools in the toolbox that you've got, of course. It makes me wonder then, Dr. Lau, from the perspective of schools, right, like what can they do? What can communities do, you know, to minimize the risk of sudden cardiac arrest?

Dr. Kelvin C. Lau: I think the schools can actually do so much and the community at large. I'll give you some examples. I've had multiple survivors of cardiac arrest and the reason they survived - and just so you know, the rate of survival is less than 10% when you have a cardiac arrest outside the hospital and, it may not be very good you may be debilitated, but what those stories that those patients all share in common are parents or schools that are prepared for these events. So, you got teachers and parents who are trained in CPR. The schools or the facilities where the competition is taking place is equipped with an automatic external defibrillator [AED].

So those are devices that can shock someone's heart out of a lethal arrhythmia. And so having those tools and those trained personnel available made all the difference. These stories, it's remarkable. These student athletes have gone down on the field, they were discovered within minutes and the people were acting really quickly.

It may even be the very first time they performed CPR, but that's all it took, that they were able to kind of immediately come to the rescue, call the right people and continue administering CPR while help is really on the way.

Scott Webb: Yeah. As you say, right? Like knowing CPR, having those folks around, having the AEDs, knowing where they are, being able to access them, you know, all of that is important. Because time is of the essence. Time is heart, of course, as we know. Just want to finish up today, Doctor, and get a sense from you, like what's the state of Florida doing to protect student athletes?

Dr. Kelvin C. Lau: The state of Florida is kind of leading the way right now. We just passed a the Second Chance Act, so it's legislation where, starting July 1st, 2026, all students in grade nine to 12 participating for the first-time in interscholastic sports are required to get an EKG or ECG before even trying out.

So they're basically asking all the parents to get their student athletes in to their doctors getting their annual physical, but in addition, getting an ECG so that we begin trying to catch those kids who may be at-risk, and therefore if the EKG shows a potential concern, see a specialist who can really dive into figuring out whether there is anything of concern here.

Scott Webb: Yeah. That's awesome. Well, I appreciate your time today. As I said, I'm an interested party. I'm sure listeners are as well. Thank you so much.

Dr. Kelvin C. Lau: No problem. Thank you for having me.

 Scott Webb: And for more information, go to BayCare.org. And that wraps up this episode of BayCare HealthChat. Always remember to subscribe, rate and review this podcast and all of the other BayCare podcasts, so we can share the wealth of information from our experts together. I'm Scott Webb. Stay well.