Sudden Cardiac Arrest (SCA) in Youth

Sudden cardiac arrest (SCA) is an abrupt and unexpected loss of heart function. A SCA occurs unexpectedly and stops the heart from beating normally stopping blood flow to your heart and brain leading to a loss of consciousness and collapse. A SCA is not the same as a heart attack. A heart attack happens when the blood flow to your heart is cut off by a blockage. A SCA is caused by an abnormal heart rhythm. Although SCA is rare in children and youth, there are steps that can be taken to identify children who may be at risk or showing signs of a SCA. In the U.S. there is no mandatory reporting for pediatric SCA making it hard to know exactly how many events occur each year:

  • In studies among persons aged 1 through 18 years, the rate ranged from less than 1 to 4 deaths per 100,000 population per year.1
  • During 2004-2008, the rate of sudden cardiac death among National Collegiate Athletic Association Athletes was 2.3 cases per year.2
  • Three-quarters of SCA treated by EMS outside of a hospital occurs at home, with one-quarter treated in a public place.3

Knowing and not ignoring the signs and symptoms that put you at risk for a SCA is the first step in preventing a SCA. A SCA can be fatal if not treated right away. Survival relies on calling 911, starting cardiopulmonary resuscitation (CPR), and using an automatic external defibrillator (AED).

Learn the Signs, Symptoms, Personal and/or Family History of Sudden Cardiac Arrest

SCA symptoms may be misread or ignored but they should serve as red flags for an evaluation by a healthcare provider. Personal risk factors or a family history of certain conditions can increase the risk for SCA and the need for an evaluation with a healthcare provider. Talk to your child and their healthcare provider about the child's personal risk factors and family history that put them at risk for SCA.

Symptoms that indicate a risk for SCA

  • Fainting or seizure, especially during or right after exercise or with excitement or startle.
  • Racing heart, palpitations, or irregular heartbeat.
  • Dizziness, lightheadedness, or extreme fatigue with exercise.
  • Chest pain or discomfort with exercise.
  • Excessive shortness of breath during exercise.
  • Excessive, unexpected fatigue during or after exercise.

Personal Risk Factors

  • Use of diet pills, performance-enhancing supplements, energy drinks, or drugs such as cocaine, inhalants, or "recreational" drugs.
  • Elevated blood pressure or cholesterol.
  • History of healthcare provider ordered test for the heart.

Family History

  • Family history of known heart abnormalities or sudden death before age 50.
  • Family members with unexplained fainting, seizures, drowning, near drowning or car accidents before age 50.
  • Structural heart abnormality repaired or unrepaired.
  • Any relative diagnosed with the following conditions:
    • Enlarged Heart: Hypertrophic Cardiomyopathy.
    • Dilated Cardiomyopathy.
    • Arrhythmogenic Right Ventricular Cardiomyopathy.
    • Heart rhythm problems: long or short QT interval.
    • Brugada Syndrome.
    • Catecholinergic Ventricular Tachycardia.
    • Marfan Syndrome- aortic rupture.
    • Heart attack age 50 or younger.
    • Pacemaker or implanted cardiac defibrillator (ICD).

How to Prevent a Sudden Cardiac Event

  • Know your family history: Talking to your blood relatives about the family's medical history is an important step in identifying conditions that put you at increased risk for SCA.
  • Schedule and keep well-visits: The appointment provides an opportunity to review your family history and identify personal risk factors for SCA.

How to Respond to a Sudden Cardiac Arrest

  • Calling 911, starting CPR (cardiopulmonary resuscitation), and using an AED (automated external defibrillator) when someone experiences a SCA can make the difference between life and death.
  • Be prepared and reach out to organizations in your community that train people on how to perform CPR and use an AED.

Dominic Murray Sudden Cardiac Arrest Prevention Act

Although SCA is rare in children and youth, when it happens in schools or at educational events, families and communities are left devastated. To address this rare and tragic event in children and youth involved in school sports, Governor Kathy Hochul signed into law the Dominic Murray Sudden Cardiac Arrest Prevention Act (Bill A2388) on October 25, 2021 to support students and their families by:

  • Educating students and families on SCA.
  • Educating students to know the signs and symptoms that may put them at increased risk for SCA and to report any of the symptoms listed below to their parent/guardian, teacher, school nurse, or coach/athletic trainer.
  • Educating coaches to identify students displaying signs and symptoms of SCA.
  • Adding information on SCA on required school sports parent/guardian permission or consent forms.
  • Removing students from athletics who exhibit signs or symptoms of SCA and requiring students removed from athletic activities to be evaluated by and receive written and signed authorization from a licensed physician and the director of school health services before resuming athletic activities. Additionally, students who displays signs or symptoms of SCA must be removed from participating in physical activities and be evaluated and receive written and signed authorization from a healthcare provider before resuming physical activities.

Information for Schools

The New York State Education Department's Student Support Services website, linked below, contains helpful information including the memo sent to schools about the Dominic Murray Sudden Cardiac Arrest Prevention Act, a sample letter to parents and guardians, and a health history form for athletics.

NYSED School Health Services


  1. Ackerman, M., Atkins, DL., Triedman, JK. Sudden cardiac death in the young, Circulation. 2016;133, (10): 1006-1026.
  2. Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in National Collegiate Athletic Association Athletes. Circulation. 2011;123(15):1594-1600.
  3. Heart Disease and Stroke Statistics—2018 Update: A report from the American Heart Association. Circulation. 137, (12,) e67-e492.