CAREGIVER • SUNDAY, MAY 9, 2021 • 11
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Sudden cardiac arrest
possible after illness
that can lead to sudden cardiac arrest. Simply
listening to a heart cannot.
The foundation, which was started after
Peyton died in 2013, provides four to six heart
screenings per year at different
Central Pennsylvania schools.
One of the foundation’s victories
during the past year was seeing
Pennsylvania Senate Bill 836,
or Peyton’s Law, signed in July
2020. The act was based on similar
legislation in Texas and built
off the Sudden Cardiac Arrest
Prevention Act, which requires
student-athletes and their parents
to receive and acknowledge information
about the symptoms and
warning signs of sudden cardiac
arrest as part of the pre-participation
physical exam forms from
One thing parents
and studentathletes
on the lookout for,
Apollo said, is
developing
symptoms such as
chest pain,
shortness of
breath, shortness
of breath with
exertion,
lightheadedness
and passing out,
after the child
gets back to
regular activity
and competition.
the Pennsylvania Interscholastic
Athletic Association.
Because of Peyton’s Law, they
must now also get information
about EKG testing and the option
to request an EKG from the student’s medical
provider as part of a comprehensive exam.
Pennsylvania is only the second state, in
addition to Texas, to have such legislation.
With the information now available about
how covid-19 can potentially impact the
heart, Walker believes it’s even more important
to make sure parents are aware of
heart screenings.
Dr. William Apollo, medical co-director
of UPMC Sports Cardiology, was on hand
to assist in April when the Peyton Walker
Foundation and volunteers conducted heart
screenings of Pennsylvania’s Big 33 football
team, an all-star collection of the state’s top
players. After initially believing covid-19 was
a respiratory illness, he said, they now know
that it is a systemic inflammatory illness that
can cause heart problems in some patients.
The important thing to remember, Apollo
said, is that young, healthy athletes generally
do well with covid-19 infections and get over
the illness without complications.
“If you have a child or teen who had a
covid infection, I think definitely their doctor
should know about it, but most of those
people will do fine,” he said.
If you have a child who was moderately
sick with covid-19 — a persistent high fever,
profound fatigue, body aches — with symptoms
that lasted more than 10 days, he said,
they should probably be seen by a physician
with consideration as to whether or not further
testing is necessary before returning to
play and competition.
“Bloodwork, perhaps an EKG,
echocardiogram or ultrasound to
make sure the pumping function
is OK,” he said. “What those tests
are designed to do is to determine
whether the patient has evidence
of myocarditis, or heart muscle
inflammation. If there is evidence
of myocarditis in these athletes,
then activity needs to be significantly
restricted on the order of
months.”
The Mayo Clinic defines sudden
cardiac arrest as the abrupt loss of
heart function, breathing and consciousness,
which usually results
from an electrical disturbance that
disrupts pumping function and
stops blood flow. It isn’t the same
as a heart attack, and if not treated
should be
quickly it often leads to death.
Much of the time, sudden cardiac arrest
is due to congenital heart defects. But, it can
also occur after someone has been ill and
suffered inflammation to the heart or after
a direct blow to the chest.
“That myocarditis would be the link with
covid-19,” Apollo said. “If you have someone
who has cardiac involvement with covid and
develops myocarditis, that would be the link
to sudden cardiac death and those are the
patients you’d want to restrict from physical
activity.”
One thing parents and student-athletes
should be on the lookout for, Apollo said, is
developing symptoms such as chest pain,
shortness of breath, shortness of breath
with exertion, lightheadedness and passing
out, after the child gets back to regular activity
and competition.
“If there were any episodes of passing
out, those would be definitely problems, in
my mind,” he said. “I would think another
thing to look for, that may be a more subtle
finding in an athlete, is if the child goes back
to competition and really can’t do as much as
they used to before, if they’re having trouble
keeping up or reaching their previous level
of activity after the convalescence from the
illness. That would be something to let the