Netflix Documentary Shines Light on Sudden Cardiac Arrest in Athletes

In Netflix’s new sports documentary Starting 5, Lebron James shares the story of his son’s health scare — shining a light on the importance of heart health for athletes.

While athletes typically enjoy better cardiovascular health than the average person due to their level of physical activity, sudden cardiac arrest is a growing concern among athletes.

Netflix’s new sports documentary, called Starting 5, shines a line on this reality.

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In the doc, basketball star Lebron James opens up about his son’s recent health scare, sharing that Bronny James suffered from sudden cardiac arrest while working out in July of 2023. James fortunately survived the experience, and it was later discovered that it was caused by an unknown congenital heart defect.

While he faced a difficult recovery period, James has since returned to play in the NBA.

But his story is not an anomaly. Sudden cardiac arrest is actually the most common cause of death in athletes, occurring in roughly one in 40,000 to one in 80,000 athletes per year, according to the most recent estimates. It is typically caused by inherited cardiac conditions in younger athletes, and atherosclerotic coronary artery disease in older athletes.

According to Matthew Martinez, M.D., the director of Atlantic Health System Sports Cardiology, the most common genetic heart disease is hypertrophic cardiomyopathy (HCM), which affects approximately 1 in 500 people and often goes undiagnosed.

“Younger athletes may have genetic heart disease like HCM, and in some cases, sudden death is the first symptom they have,” Martinez tells Healthnews.

What is HCM?

HCM is a genetic condition that makes the heart muscle thicker, which can prevent the heart from pumping blood to the body efficiently and lead to the development of scar tissue that can trigger cardiac arrest, Martinez explains.

“It's common among athletes and nonathletes,” he says. “It’s the most common genetic heart disease, and it affects men and women of all ages equally.”

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Symptoms of HCM include shortness of breath, fatigue, and exercise limitations. Since these symptoms are expected while exercising, they can be difficult to identify. Martinez says this may cause athletes to push through symptoms, thinking they’re to be expected while exercising, and not recognize that the symptom might be concerning.

“Ignoring or pushing through symptoms is what puts athletes at risk,” he says. “Symptoms that may concern a nonathlete may be overlooked as part of normal training or competition.”

Martinez says all athletes, regardless of age or sex, should have assessments to look for underlying heart disease. Since it can occur at any time of life, regardless of genetic predisposition, he says continuous evaluations are needed, and one assessment without any findings may not be enough.

Healthcare disparities

While assessments are critical, existing healthcare disparities affecting Black Americans, particularly when it comes to cardiac health, often impede young athletes and teens from cardiac screenings.

“Access to assessments and experts is the biggest disparity for cardiac health,” Martinez says. “Not all athletes have access to quality assessments and experts.”

Oftentimes, patients lack access to qualifying experts who can determine if they have an abnormal finding and what risk they might have. Martinez says access to experts can prevent unnecessary holdouts for athletes or disqualifications unnecessarily.

In addition, screenings do not always find everything, so access to emergency action plans and Automated External Defibrillators (AEDs) is critical for player health and safety.

“Make sure that the places you or your family exercise have a plan to handle sudden cardiac arrest and rapidly available AEDs,” he says. “A plan and access to AEDs are the most important ways to keep your family safe.”

And while symptoms aren’t always easy to identify, it’s still important to be aware of any red flags. Martinez says shortness of breath that is out of proportion to your effort, racing heartbeats, chest pressure or squeezing with exercise, and fainting with exercise or immediately after stopping are worrisome signs that require medical attention.

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“It’s important to have regular visits with your doctors and know your family history concerning cardiac arrest or death under age 40,” he says. “It is also good to know if your family has had any genetic heart disease in the past for first-degree relatives.”

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