With major athletic competitions descending on the city this summer, athlete health and safety will be in the spotlight. 

Experts at the Sports Cardiology Clinic at St. Michael’s Hospital, say these high-profile events are an important opportunity to raise public awareness about CPR training and the life-saving impact of rapid response. While cardiac arrest during sport is rare, timely intervention can make the difference between life and death.

“They draw attention to an issue that affects people far beyond professional sport,” says Dr. Paul Dorian, a staff physician in the Division of Cardiology and Sports Cardiology Clinic. 

Katherine Allan, a researcher at St. Michael’s Hospital, says sport-related cardiac arrest occurs in about 1.2 cases per 100,000 people and accounts for about five per cent of all cardiac arrests.

Middle-aged men, especially recreational athletes, face a much higher risk than women during sports, Dorian says. Men are 16 times more likely than women to experience a sport-related cardiac arrest. Many people in this group may have underlying coronary artery disease and may not exercise regularly before taking part in intense physical activity.

Screening can identify some heart conditions, but it does not detect every risk. In fact, even many elite athletes who experience cardiac arrest during physical activity have already undergone testing that has shown no abnormalities. In some cases, the cause can be a rare inherited condition the person did not even know they had.

Most importantly, Allan and Dorian say a spectator at a sporting event is more likely to experience cardiac arrest than an elite athlete competing on the field.

Spotting cardiac arrest and the importance of responding quickly

Warning signs can be easy to miss because they may look like other health problems. 

“Screening can help, but it has clear limits,” says Dorian. Athletes may be asked about fainting, chest pain, shortness of breath and family history. Others may also have a test to track electrical signals in the heart, called an electrocardiogram (ECG), but even regular screening does not catch every condition. In other cases, cardiac arrest can happen suddenly with little or no warning.

When cardiac arrest happens, every second counts. CPR from a bystander can double or triple a person’s chance of survival. An automated external defibrillator (AED) is designed for public use and can help restore a normal heart rhythm. When an AED is available and used quickly, survival rates double.

“Many people do not know where to find an AED in an emergency,” Allan says. “That is why it is so important to call emergency services, begin chest compressions and use an AED if one is available.”

Building awareness beyond the headlines

Response to a cardiac event at a large sporting event is often rapid and well-coordinated, with trained staff and accessible automated external defibrillators (AEDs) on site.

In recreational settings, however, there may be less training, lower awareness and fewer AEDs nearby. Outcomes can be worse in these environments if bystanders do not recognize cardiac arrest and act quickly.

“Knowing how to respond to cardiac arrest is a skill everyone should have. Consistent public messaging and CPR training should always be front and centre,” says Allan.

Emergency response plans across communities can help ensure AED access, CPR training and preparedness remain top of mind so people are ready to act when it matters most.

What to do if someone collapses

  • Call 911 immediately
  • Check responsiveness (call their name, shake gently)
  • Start chest compressions right away
  • Use an AED (defibrillator) if available

Recognizing cardiac arrest

Many people hesitate because they are unsure what to do or fear doing it wrong. In a cardiac arrest:

  • The person is unresponsive
  • They are not breathing normally (or only gasping)
  • Every minute without help reduces survival

Even imperfect action can save a life. Bystanders who step in to help are protected under Good Samaritan law. If you act in good faith, you are protected while trying to save a life.

Building lifelong awareness

Improving outcomes start with education, especially at a young age. Programs like Heart & Stroke’s “Cardiac Crash” app use gamified, video-based learning to teach children how to recognize cardiac arrest, perform CPR and use an AED.

Making CPR education accessible and engaging helps build confidence early and equips more people with the skills needed to respond, whether at home, in the community or at a sporting event.

“Sports are generally safe and offer many health benefits, and people should be encouraged to take part for their overall health,” Allan says. “But knowing how to recognize cardiac arrest and how to respond can save a life.” 

The Sports Cardiology Clinic at St. Michael’s Hospital

The Sports Cardiology Clinic at St. Michael’s Hospital supports a wide range of patients, from elite athletes to serious recreational competitors and older adults who remain highly active. “Our role at the clinic is to assess possible heart concerns, distinguish between a healthy athlete’s heart and underlying disease, guide return-to-play decisions and help people understand their level of risk,” Dorian says.

The goal is not to tell athletes to stop all activity, but to help them continue safely and realistically with the right treatment, monitoring or exercise prescription.

By Jade Vyfhuis

Related Tags