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Buffalo Bills safety Damar Hamlin

Cardiac Arrest During NFL Game Brings Awareness to Importance of High-Quality Intervention

Damar Hamlin, a safety for the Buffalo Bills, experienced cardiac arrest Monday night after making a tackle.

Written by Rachel Sauer on January 4, 2023

Editor’s Note: Since this story first published, Damar Hamlin was discharged from a Buffalo, New York, hospital January 11 and on January 28 released a video updating his fans and community on his recovery.

Buffalo Bills safety Damar Hamlin, 24, remained in critical condition Wednesday after collapsing on the football field six minutes into the first quarter of Monday night’s game against the Cincinnati Bengals.

Hamlin experienced cardiac arrest after tackling Bengals’ wide receiver Tee Higgins. According to a statement released by the Buffalo Bills organization, “His heartbeat was restored on the field and he was transferred to the University of Cincinnati Medical Center for further testing and treatment. He is currently sedated and listed in critical condition.”

Athletes and football fans around the country, as well as the National Football League, have expressed support for Hamlin and his loved ones. They also have brought significant attention to not only sudden cardiac arrest, but the importance of immediate response when it happens.

Muhammad Aftab, MD, an associate professor of cardiothoracic surgery in the University of Colorado School of Medicine, explains more about sudden cardiac arrest and the necessity for a quick response.

Header image: Ben Green/Buffalo Bills, LLC

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What is cardiac arrest?

Cardiac arrest refers to the arrest of electrical activity in the heart – something in the heart’s electrical system malfunctions. In turn, that stops the heart beating and can lead to a loss of breathing and consciousness. Cardiac arrest is a manifestation of some other problem and isn’t the same as a heart attack, which happens when blood flow to part of the heart is blocked. For a healthy individual who’s younger than 30, cardiac arrest is quite rare.

What can cause cardiac arrest?

Unfortunately, almost any heart condition can cause cardiac arrest. In younger, very healthy individuals, causes for cardiac arrest can include coronary artery abnormalities, which may be congenital or undetected. They may also include hypertrophic obstructive cardiomyopathy, which causes the heart muscle to become thickened and makes it more difficult to pump blood. Some athletes who play contact sports can experience a condition called commotio cordis, which can happen as a result of chest trauma at a vital time during the heartbeat.

I’m not going to speculate that’s what happened in this situation because again, it’s just one possible cause of cardiac arrest. One of the most common causes of sudden cardiac arrest are arrythmias, where the heart rhythms are abnormal. There are different kinds of arrhythmias – ventricular fibrillation, for example, happens when impulses from the heart’s lower chambers are erratic.

What are some of the risk factors of cardiac arrest?

Risk can vary by age, physical condition, and other factors. Cardiac arrest is more common in older individuals, and some of the risk factors may include coronary artery disease or valvular heart disease, arrhythmias, or congestive heart failure with cardiomyopathy. A previous history of heart attack can also be a significant risk factor, as well as conditions such as diabetes or obesity.

In younger patients, some of the risk factors can be a family history of sudden cardiac arrest or sudden cardiac death, a history of congenital heart defects, and hypertrophic cardiomyopathy. Because cardiac arrest is so rare in younger people, professional athletes and those with certain risk factors should talk with their health care provider about EKG or echocardiogram screening. A thorough physical exam can also be a good place to start in detecting possible risks for cardiac arrest.

Can CPR make a difference when someone has experienced cardiac arrest?

One thing that has significantly impacted survival with sudden cardiac arrest is high-quality bystander CPR. When someone gets cardiac arrest, if the people nearby are certified to perform high-quality CPR and immediately start, the outcomes can be very very good. One patient we had a few months ago, a 70-year-old who was walking through DIA, rushing to a flight, got cardiac arrest. Fortunately, EMS was available and they started high-quality CPR right away and also used the defibrillator once or twice, so this patient was conscious right away. I performed quadruple bypass and this person has been able to completely recover, so the lesson for us is that high-quality CPR can save lives, save the brain, and prevent stroke. Within four to five minutes after sudden cardiac arrest a person is at very high risk for brain damage, and after eight minutes they’re at very high risk of death. But high-quality CPR can maintain the blood pressure if it's instituted immediately by bystanders, and if more people are able to administer it, one can perform chest compressions while another runs for help.

Again, I can’t speculate on what happened after the football player collapsed, but we know that he received immediate intervention. So, a lesson may be to look into receiving high-quality CPR training and making sure those skills stay updated.

Another lesson is to pay attention to your body and to your heart. If you’re experiencing chest pains or shortness of breath, or if something just doesn’t feel right, ask your health care provider about it immediately.

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Muhammad Aftab, MD