*This is the 1st of a series regarding Zac Mago and Sudden Cardiac Arrest
LAKEVILLE, IN. – Most sudden cardiac deaths are caused by abnormal heart rhythms called arrhythmias. The most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganized firing of impulses from the ventricles (the heart’s lower chambers).
Most sudden cardiac arrests happen in people who appear healthy and have no known heart disease or other risk factors for sudden cardiac arrest.
Such was the case for Zac Mago, a John Glenn student, during the summer of 2018. Mago was a student at Glenn and unexpectedly passed away on July 5, 2018, while taking a nap. Zac died from Sudden Cardiac Arrest attributed to an enlarged heart. There is nothing natural about a healthy 17-year-old, one week shy of his 18th birthday dying. To carry on Zach’s memory, the Zac Mago Foundation was founded.
To shed more light on Sudden Cardiac Arrest and hopefully prevent future SCA from occurring in young people, the Mago Foundation has partnered with mCORE (Mobile Cardiac Overview and Risk Evaluation) to make screenings available and affordable for conditions that could lead to Sudden Cardiac Arrest.
The Mago Foundation and mCORE will be screening LaVille High School senior athletes on May 1. The cost per screening is $75 and Zach’s Foundation will pay $55. The Mago Foundation is asking parents to pay a small copay of $20. A scholarship is available for those who can’t afford the $20 co-pay.
Parents and students would sign up directly on the mCore HIPPA compliant website. This screening includes both an EKG and limited Echocardiogram. They have less than a 1% false positive rate. The reason for this is they do both tests, not just an EKG, which does tend to have a higher rate of false positive.
Each year, EMS treats nearly 300,000 people who suffer cardiac arrest outside the hospital. More than 92 percent of cardiac arrest victims don’t survive to be discharged from the hospital. In cities where defibrillation is provided within 5 to 7 minutes, the survival rate is as high as 30–45 percent.
There are more than 356,000 out-of-hospital cardiac arrests (OHCA) annually in the U.S.; nearly 90% of them fatal, according to the American Heart Association’s newly released Heart Disease and Stroke Statistics – 2018 Update. According to the report, the annual incidence of EMS-assessed non-traumatic OHCA in people of any age is estimated to be 356,461.
There are a number of ongoing challenges to understanding the epidemiology of cardiac arrest in the U.S. Despite being a leading cause of death, there are currently no nationwide standards for surveillance to monitor the incidence and outcomes of cardiac arrest. Thus, registries and clinical trials are used to provide best estimates.
Following are highlights from the report:
- Estimates suggest the incidence of OHCA among adults is 347,322.
- Overall, survival to hospital admission after EMS-treated non-traumatic cardiac OHCA was 29%, with higher survival rates in public places (39.5%) and lower survival rates in homes/residences (27.5%) and nursing homes (18.2%)
- Survival to hospital discharge was 10.8% among adults (9% with good neurological function).
- Large regional variations in survival to hospital discharge (range, 3.4%-22%) and survival with functional recovery (range, 0.8%-20.1%) are observed in 132 counties in the U.S. Variations in the rates of layperson CPR explained much of this variation.
- Among adults treated by EMS, 25% had no symptoms before the onset of arrest.
- The majority of OHCA’s occur at a home or residence (68.5%), followed by public settings (21%) and nursing homes (10.5%).
- A bystander in 37% of cases, and an EMS provider in 12% of cases witnessed cardiac arrest. For 51% of cases, the collapse was not witnessed.
- Among EMS-treated OHCA patients, 19.8% had an initial rhythm (Ventricular Fibrillation or Ventricular Tachycardia) that is shockable by an automated external defibrillator (AED).
- Among 10.9 million registered participants in 40 marathons and 19 half-marathons, the overall incidence of cardiac arrest was 0.54 per 100,000 participants. Those with cardiac arrests were more often male and were running a marathon versus a half-marathon. Among runners with cardiac arrest, 71% died; those who died were younger (39+9) than those who survived 49+10).
|Annual Incidence of EMS-Assessed OHCA|
- Estimates suggest the incidence of EMS-assessed OHCA among children (<18 years of age) is 7,037.
- Survival to hospital discharge was 10.7% among children (8.2% with good neurological function).
- The location of EMS-treated OHCA was at home for 89.5% of children <1 years old, 77% of children 1-12 years old, and 72.9% for children 13-18 years old.
- The most common causes of SCD among young athletes are hypertrophic cardiomyopathy (36%), coronary artery abnormalities (19%), myocarditis (7%), arrhythmogenic right ventricular cardiomyopathy (5%), coronary artery disease (4%), and commotio cordis (3%).
- The incidence of SCD was 0.24 per 100,000 athlete years in high school athletes screened every three years between 1993 and 2012 in Minnesota.
- The incidence of non-traumatic OHCA was 1 per 43,770 athlete participant-years among students 17-24 years old participating in NCAA sports from 2004-2008. The incidence of cardiac arrest was higher among blacks than among whites and among males than among females.
|Characteristics of and Outcomes for OHCA|
|Survival to hospital discharge||10.8||10.7|
|Good functional status at hospital discharge||9||8.2|
- A family history of cardiac arrest in a first-degree relative is associated with an ~2-fold increased risk of cardiac arrest.
- According to 2017 figures from the CDC, SCD appears among the multiple causes of death on 13.5% of death certificates, which suggests that 1 of every 7.4 people in the U.S. will die of SCD. Among adults, the risk of SCD increases exponentially with age.
- Survivors of cardiac arrest experience multiple medical problems including impaired consciousness and cognitive deficits. As many as 18% of OHCA survivors have moderate to severe functional impairment at hospital discharge. Functional recovery continues over the first six to 12 months after OHCA in adults.
Healthcare Utilization and Cost
- The estimated societal burden of SCD in the U.S. was 2 million years of potential life lost for males and 1.3 million potential life lost for females, accounting for 40-50% of the years of potential life lost from all cardiac diseases.
- Among males, estimated deaths attributed to SCD exceeded all other individual causes of death, including lung cancer, accidents, chronic lower respiratory disease, cerebrovascular disease, diabetes mellitus, prostate cancer, and colorectal cancer.
Awareness and Treatment
- The median annual CPR training rate for U.S. counties was 2.39%, based on data from the AHA, American Red Cross and the Health & Safety Institute, the largest providers of CPR training in the U.S. The prevalence of reported current CPR training was 18%, and the prevalence of having CPR training at some point was 65%. Training rates were lower in rural areas, areas with high proportions of black or Hispanic residents, and counties with lower median household incomes.
LaVille Jr.-Sr. High School currently has two AEDs (Automated External Defibrillators) inside the building – one in the athletic area and one in the front hallway across from the main office.
When asked about the importance of AEDs in the school, LaVille Athletic Trainer Gary Hall said: “They are extremely important. Without them you are waiting on EMS or someone that knows how to do CPR. If you do not know how to use an AED, the AED pretty much talking you through each step. It tells you what to do. I’m so thankful we have them.
When Hall learned that the Mago Foundation was teaming with mCORE, Hall said: “I think this is fantastic. It is needed. Hopefully we can find kids with issues they didn’t know about and get further testing. Without it, we don’t know if they would have an issue. It is so nice! I don’t know how many kids will sign up, but I know my daughter is going to do it.”
mCORE Questionnaire & Waiver Form