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LAPORTE, Ind. —
Jake West, Zac Mago and Mark Mayfield all died of sudden cardiac arrest. All unexpected. All their deaths possibly preventable, say their moms.
"Undetected heart conditions were not on our radar at all because we had healthy boys," said Julie West. "They passed every physical and never complained."
One athlete is too many, say the moms of Jake, Zac and Mark.
These moms are on a mission to raise awareness of sudden cardiac arrest, its signs and symptoms, to push for automatic external defibrillator (AEDs) in schools and on sports fields, to advocate CPR training and heart screenings for athletes.
"We don't want any other family to feel what we feel," Julie said.
"Sometimes I say, 'Is this my world? Is this really my world?'" Teresa Mago said.
"If Mark was my only child, I don't know if I'd be here, honestly," said Diane Mayfield.
Their boys are gone. But these moms want the stories of their sons to be heard, the stories of young men who were just starting out in life, the stories of three 17-year-old seemingly healthy athletes who died.
In its simplest explanation, sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from a problem with the heart's electrical system, which disrupts the heart's ability to pump and stops blood flow to the body.
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"Sudden cardiac arrest is the fatal arrest when the heart stops beating," said Richard Kovacs, a cardiologist with Indiana University Health. "And that requires immediate attention or the athlete dies."
In high school athletes, sudden cardiac arrest is the No. 1 cause of death. But stats on how prevalent it is vary greatly, depending on the research, ranging from 1 in 40,000 to 1 in 80,000.
"The point is it's very rare but even though it's rare, it's tragic," said Adam Kean, cardiologist and electrophysiologist with Riley Children’s Health. "But it's tragic in a much more personal way. Kids in the prime of their lives who are often in prime health and, in front of everyone, they go down suddenly. And that is incredibly emotional and traumatic to deal with."
Sudden cardiac arrest has many causes. Among them are coronary artery disease, heart attack, enlarged heart, valvular heart disease, a heart defect present at birth and electrical problems in the heart. Sometimes, an accidental blow to the chest can also stop the heart.
The symptoms of sudden cardiac arrest, unfortunately, overlap with what many athletes feel almost every day, said Kovacs. Shortness of breath, chest pain, a very fast heartbeat.
Athletes routinely push themselves and many may feel those types of symptoms now and then, said Kovacs.
What he worries about, said Kovacs, are the unusual symptoms. A player who is short of breath doing something he wasn't short of breath doing in the past. A racing heart for no reason. Or chest pain that is unusual, not a muscle pain, but a pain deep down inside.
"If your son or daughter has symptoms that don't seem right, go get them evaluated," he said. "Their life is more valuable than their participation in next week's scrimmage."
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The risk of suffering sudden cardiac arrest is 10 times higher during practice or play, Kovacs said, because the heart has to work harder. About 2,000 people younger than 25 die each year from sudden cardiac arrest, according to the American Academy of Pediatrics. There is no breakdown of how many of those are high school athletes.
Jake: 'He had my heart, always'
Jake died of arrhythmogenic right ventricular cardiomyopathy (ARVC), a disease of the heart muscle. When fatty, fibrous tissue replaces normal heart muscle, this interrupts normal electrical signals in the heart and may cause irregular and potentially life-threatening heart rhythms.
Jake West sent a text to his mom. The D-line wanted to go to Buffalo Wild Wings after football practice and he didn't have enough money.
Julie pulled into the LaPorte High football parking lot before practice on that fall day, Sept. 25, 2013, with some extra cash for Jake.
There he was, walking up with a smile on his face. There he was, hanging into her passenger window, asking how she was, grabbing the money. There he was, all 6 feet of him ready to practice, his usual, happy self.
Jake West never got to go with the D-line for dinner, for chicken wings and baskets of fries. After his mom left, he headed to practice.
During a play, Jake collapsed on the field.
Jake was one of two children, the baby brother to older sister Courtney. Growing up, he was always involved with sports, always outside playing with his friends.
"So as a mother you think, 'Kids are outside playing, they're healthy, you want them exercising,'" said Julie.
Jake played varsity football and lacrosse. He made goofy videos with friends. He was hilarious, his mom said, and could light up any room. He was also a bit of a momma's boy, often writing little notes to Julie.
"I tell you, he had my heart always," she said. "He just was a little protector."
After Jake died, Julie asked for an autopsy.
When the autopsy came back that Jake had ARVC, an undetected heart condition, Julie was in shock.
"He made it through every physical, never a sign or symptom," she said. "Never in a million years would I think anything was wrong with his heart."
When Jake collapsed an AED wasn't on the field; it was in the coach's office. An AED could possibly have saved Jake's life.
An AED is used to help people suffering sudden cardiac arrest. It's a medical device that can analyze the heart's rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish the proper rhythm.
"That is something we are all working toward," Julie said, "getting those AEDs right there on the field and readily available."
For Jake, there was no heart history, no family heart history. But after his death, the Wests were tested and they learned there was.
Courtney was in college when her brother died. She, too, was an athlete, a volleyball player who had never had any signs or symptoms. Within a month and a half of losing Jake, Courtney learned she had the exact same condition as her brother.
Doctors implanted a subcutaneous cardioverter defibrillator, an electronic device to constantly monitor her heart rhythm. The cardiologist told Courtney that Jake had saved her life.
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Julie had been an athlete her entire life, playing sand volleyball as a setter.
"I thought anything that I would feel playing was normal to me," she said. "But as I got older, after running a play, I'd get done and I remember my heart racing."
Julie attributed the feeling to being out of shape. She knows now she was wrong.
"I could have died anytime," she said. "I don't want to say I wish I would have, but I would die before my children. We all would give our lives right now for our children."
Jake's story shows just how important heart screenings are for athletes. If Julie had had one, she might have saved Jake's life. But she can't live in a world of what-ifs. She tries, instead, to live with the wonderful memories of Jake.
Zac: Witty, smart, fun-loving
Zac died of an enlarged heart with fibrosis of the left anterior papillary muscle.
Zac Mago was asleep the morning of July 5, 2018.
His mom Teresa Mago peeked in on Zac sleeping in his bed about 7:30 a.m.
There he was asleep, one week shy of his 18th birthday, so peaceful.
Zac Mago got up that morning of July 5, after his mom had peeked in on him. He and his sister Jillian went to their grandma's for breakfast. Zac didn't eat as he normally did, not like a 6-5, 200-pound athlete usually eats.
After breakfast, Zac was supposed to take his grandma shopping, but he called Teresa and said he didn't feel well. He went up to his room to sleep.
Later that afternoon when Teresa came home, Jillian went upstairs to tease Zac. "Ha, ha mom's home. You've got to get up now." Zac didn't budge.
Jillian rolled Zac over. He was blue and not breathing. She screamed "Call 911." Teresa raced upstairs to his room, called 911 and helped their aunt Tonya get Zac off the bed. Tonya started CPR with the operator helping to guide her.
"And he was gone," Teresa said. "We were too late."
Zac was a leader in his class, ranked in the top 10. And he was an athlete. Zac had wanted to play football, too. But Teresa, thinking she was shielding him from a more dangerous sport, bribed him. She would pay his AAU basketball fees if he didn't play football.
"And I thought I was protecting him," she said. "Little did I know."
Where Zac's story is different from Jake's and Mark's is that he did have a full heart screening in 2014. It was done after a school physical where doctors thought they heard a heart murmur. Teresa took Zac to his pediatrician who ordered an EKG and echocardiogram. Everything came back normal.
"And in four years, he was gone," she said. Teresa knows now, Zac should have gotten screenings every two years after his first one, but she said the family wasn't told that. The development of the heart changes as kids grow. And Zac grew nine inches in 18 months after that first heart screening.
"That's my words to everyone now," Teresa said. "It's not one and done."
Medical professionals pinpointed Zac's time of death based on his body temperature. He had died 18 minutes before his sister found him. Even an AED wouldn't have saved his life; he died in his sleep.
Mark: 'He was so sweet and good'
Mark died from arrhythmogenic right ventricular cardiomyopathy (ARVC), due to a genetic heart condition.
The morning of Jan. 23, 2017, Diane Mayfield was texting her son before school. "Are you up?" Yes, he was up. Mark had a big day. It was offseason for the baseball star at New Prairie High, so he was playing an intramural basketball game after school.
Mark Mayfield had just played hard in that intramural basketball game; he never did anything halfway, said his mom. He walked off the court and down the hall to get a drink.
Mark collapsed going to get that drink. A friend found him.
Baseball had always been his thing.
By the time Mark was two years old, he was throwing a Wiffle Ball up and hitting it. Diane couldn't believe it. As he grew older, Mark, the fifth of eight children, played every sport. He wrestled, played football and basketball, but baseball was where he really shined.
His parents always thought he would play baseball in college but, shortly before he died, Mark told them he didn't want to. Diane wonders now if the exertion was too much, if maybe he was feeling symptoms he wasn't telling them about.
She looks back at the summer before he died, when Mark was playing in a game. He got to second base and stood there bending over, trying to breathe.
It was hot that day and Mark's dad had asthma.
"I just thought it was anything but a heart thing," said Diane. Mark had a heart screening just three months before he died, an EKG but not an echocardiogram. The EKG came back clean.
When Diane got the call that Mark was down in the hallway after that intramural basketball game, she never imagined a heart issue. She thought maybe he had hurt his leg or broken an ankle.
"Then it's like, 'What?'" Diane said. "We learned, sometimes, the first symptom is death."
An AED wasn't available at the school. It might have saved Mark's life.
After Mark died, the family found out that three of his siblings have the same gene defect Mark did. They are told not to overexert. Other family members have also learned they have heart conditions.
Three moms, a teacher fight back
The moms of Jake, Zac and Mark are not going to sit back. Had AEDs been on hand, had they been aware of the signs and symptoms of sudden cardiac arrest, had they known the rules on heart screenings, their sons might be alive.
They are on a mission to change that for others. "We were two voices, three voices, then four voices," said Teresa. "Four voices are better than just our own."
That fourth voice is Tonya Aerts, a biomedical teacher at Mark's school, New Prairie. She said the school and community were devastated by Mark's death and she set out to do something about it.
The four women have been advocating for and offering CPR training, pushing for working AEDs in all places sports are played or practiced and educating students, parents and coaches about the signs and symptoms of sudden cardiac arrest.
After Mark's death, when they went to look for an AED at his school, they found it with dead batteries, under popcorn by the microwave, locked inside the concession stand.
With Aerts pushing, the school recently became Indiana's first Heart Safe School through Project Adam, which helps to implement a plan at schools to respond to a sudden cardiac arrest.
As important as having AEDs on hand and CPR training is the response, said Kean, who is leading the Indiana affiliate of Project Adam.
"There are going to be kiddos, even if they do have the gold standard cardiac workup, who are going to suffer sudden cardiac arrest," he said. "Having the people on the field or the court who know what to do?"
It's crucial. The best chance for an athlete to survive a sudden cardiac arrest is when bystanders respond — not when EMS gets to the scene.
One of the first hurdles to get over is the average person's fear of using an AED, said Aerts. People worry about the device giving a shock to someone who doesn't need it; it won't. They worry they have to be medical personnel to use it; they don't. There are step-by-step instructions on the device.
"If you go grab the AED and you don't need it, put it back, no problem," said Aerts. "Anyone can grab it. The fourth grader can grab it. Just get it."
Julie and Teresa have set up foundations that offer heart screenings and CPR training in honor of their sons. After Mark died, Diane got a job issuing CPR cards with the American Heart Association training center for South Bend, Indiana.
"It's such an unfortunate platform that we have. I shouldn't know these names under these circumstances," said Aerts. "I should only know Zac because he's running his mom's business now and Jake because he's in college and Mark because he's playing baseball somewhere and we are so proud of them. I shouldn't know their names because of this. But there will be more. Why would there not be?
"Why not be prepared to stop it from happening again?"
Learn more, save lives
-- October is Sudden Cardiac Arrest (SCA) Awareness Month.
-- Get involved. Ask your school or athletic office if there are working, accessible AEDs.
-- Pediatricians and other primary care providers should evaluate whether a patient’s clinical history, family history or physical examination suggests a risk for sudden cardiac arrest or sudden cardiac death.
-- If there is a concern, an electrocardiogram should be the first test administered and it should be interpreted by a physician trained to recognize electrical heart disease. The doctor should factor in a patient’s clinical history and consider referral to a specialist.
-- Know these key questions. Has your child or teen ever fainted, had an unexplained seizure, experienced chest pain or shortness of breath? Does their heart beat rapidly sometimes even at rest? Does anyone in the family have a history of cardiac conditions or death before age 50?
-- Learn how to become a Heart Safe School through Project Adam, https://www.projectadam.com/, which began in 1999 after the death of Adam Lemel, a 17-year-old Whitefish Bay, Wisconsin, high school student who collapsed and died while playing basketball.
Follow Dana Benbow on Twitter: @DanaBenbow.
This article originally appeared on Indianapolis Star: Indiana high school athletes die of sudden cardiac arrest