Christian Eriksen Cardiac Arrest: On Saturday, June 12th, 2021, Christian Eriksen, a 29-year-old from Denmark, suddenly collapsed on the pitch of Parken Stadium during his country’s Euro 2020 game against Finland due to his heart going into sudden cardiac arrest. Christian Eriksen’s heart wasn’t able to pump blood to his brain; he lost consciousness and fell to the ground. Within minutes the medical staff surrounds him. They check a pulse, there’s no pulse, so they start CPR, and he gets one shock to his chest to defibrillate his heart. Fortunately, they were able to resuscitate Christian Eriksen successfully, and he is doing well now.
Christian Eriksen Cardiac Arrest and Defibrillator
By the time you are watching this, he has probably already had an extensive cardiac workup, including bloodwork measuring troponin levels, EKGs, an ultrasound of the heart, meaning an echocardiogram, and a cardiac MRI.
Christian Eriksen is far from the only young athlete to sudden cardiac arrest while playing a sport. Reggie Lewis with the Boston Celtics. Hank Gathers with Loyola. Between 2004-2007, soccer players Marc Vivien Foe, Miklos Feher, and Antonio Puerta died of sudden cardiac arrest, which led to FIFA enforcing players to be screened before competitions at ALL levels. Thankfully Francis Muamba survived in 2012.
Sudden cardiac death is defined as unexpected death due to a previously unknown heart condition, and it occurs within 1 hour of symptom onset. The incidence of SCD among young athletes is pretty low, around 1:75,000 young athletes per year. Normally, a healthy heart is in a sinus rhythm. Chances are, if you’re watching this, you are in sinus rhythm, which means if you check your pulse, there is a consistent rhythm to it. How does this happen?
The beginning of the electrical signal in the heart originates in the sinus node, which is located in the right atrium. Think of the sinus node as the drummer of a band. Sure he might be a little crazy. But it’s the drummer’s job to keep the timing smooth and steady, to keep a consistent pace. For example, let’s say the song is at a tempo of 100 beats per minute. The rest of the band is in sync with the drummer at 100 beats per minute.
The last thing you want is the guitarist to be soloing at a tempo of 130 beats per minute, the frontman singing at 170, and so on. Because that leads to nothing but noise and not music, and that’s essentially what happens with the heart, right before someone has a sudden cardiac arrest. This is called Ventricular Fibrillation, aka VFib. In essence, the heart’s ventricles are not pumping blood to the body because the electrical circuit is going hey-wire, completely out of sync. They are doing nothing more than quivering.
At this moment, if the heart is not defibrillated, meaning shocked with a jolt of electricity, the heart will soon be in even more trouble, something called asystole. In other words, zero electrical activity in the heart. The chances of reviving someone at this point become even slimmer.
When someone has a sudden cardiac arrest, another rhythm called ventricular tachycardia sometimes precedes VFib. This is when the origin of the electrical activity is in the ventricles instead of the sinus node in the atria. Persistent VTach often deteriorates into VFib, and that is why VTech needs emergency medical attention. And this is why AEDs are so important. An AED is an automated external defibrillator. You turn it on, put the pads on the chest, it senses if it should shock the patient, and if appropriate, it delivers a shock in an attempt to reset the heart.
AEDs and sideline medical teams with specialized training in CPR are required at every professional soccer stadium in the world. Had Christian Erikson not had CPR with an AED put on his chest within minutes, his chances of survival would have been minimal. After one defibrillation, his heart went back into sinus rhythm. Thankfully not only did he survive, but he didn’t require a breathing tube to be put in, which is usually the case when someone has a cardiac arrest. Because when the heart stops, the cessation of breathing soon follows.
So why would an athlete, who by all means is in superb physical conditioning, and of extraordinary health, all of a sudden have their heart stop? Although it rarely happens, there are many different causes of sudden cardiac arrest in a young athlete.
Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine
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