ABC Issues Statement on Buffalo Bills Safety Damar Hamlin's Return to the NFL

WASHINGTON, June 20, 2023 /PRNewswire/ -- On behalf of the Association of Black Cardiologists (ABC), we extend our heartfelt well wishes and unwavering support to National Football League (NFL) player Damar Hamlin, who experienced a sudden cardiac event early this year. We recognize the gravity of this event and its impact on him, the NFL community, the country, and the world. Damar's strength and resilience are commendable, and his dedication to sudden cardiac death awareness is inspiring. While our team members were not directly involved in his evaluation, we agree that a diagnosis of commotio cordis is the most likely if a comprehensive cardiac evaluation was normal. Commotio cordis occurs when there is an untimely, focal, high-velocity impact to the chest wall during a narrow, vulnerable period of the cardiac cycle. This diagnosis is extremely rare, and can occur in a normal heart. The decision regarding the resumption of competitive sports should be predicated upon a meticulous appraisal of Damar's specific condition, the underlying etiology of the cardiac event, and the potential risks at stake. The ABC ardently advocates for the principles of shared decision-making in sports cardiology, wherein medical professionals collaborate with the athlete, their family, the organization, and a multidisciplinary team to ascertain the safest course of action regarding return-to-play. With appropriate medical care, rehabilitation, and understanding of risk, we support him returning to the NFL if he so wishes.  Additionally, we pray that he receives the full support of the NFL and the nation for his psychological recovery.

Sudden cardiac death (SCD) is a complex event with many potential underlying mechanisms that may lead to a sudden cessation of effective cardiac pumping and loss of pulse. In individuals predisposed to SCD, the pathophysiology involves a combination of structural abnormalities of the heart, inherited cardiac conditions, and electrical disturbances. In an attempt to detect cardiac abnormalities that increase an athlete's risk of exercise-related SCD, preparticipation evaluations (PPE) can be helpful.  However, despite best efforts and screening, tragic events may still occur. Once abnormalities are identified on screening, appropriate downstream testing is required. It is crucial to acknowledge the disparities that exist in the diagnosis of predisposing conditions related to SCD. Specific populations, particularly Black individuals, face inequities in accessing comprehensive downstream cardiac evaluations, including imaging, stress testing, genetic testing, and advanced invasive diagnostic modalities. This can impede the identification of underlying cardiac conditions, thereby hindering targeted prevention strategies.

Furthermore, disparities in sudden cardiac arrest and resuscitation outcomes have been observed, with lower survival rates among certain racial and ethnic groups. Epidemiological studies, including that by the National Collegiate Athletic Association (NCAA), have highlighted Black male athletes as the highest-risk individuals compared to white athletes. To date, there has been no biological explanation for these discrepancies. The ABC asserts that addressing adverse social determinants of health is necessary to achieve equitable healthcare and rectify these disparities to ensure the well-being of all athletes. 

It is essential to acknowledge the excellent, immediate resuscitation that Damar Hamlin received on an NFL field with athletic trainers skilled in cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and emergency medical transport. It exemplified the well-executed emergency action plan (EAP) that every sporting facility and organization is encouraged to have. Unfortunately, millions of student-athletes throughout this country are not afforded these resources, mainly in impoverished environments especially in Black and Hispanic communities. Lack of athletic trainers and functioning AEDs leads to less survival among these athletes. The ABC endorses and supports the Access to AEDs Act. This bipartisan bill will increase access to life-saving equipment, CPR education, and training for schools nationwide to improve outcomes of sudden cardiac arrest for all. 

The ABC remains unwavering in our commitment to raising awareness regarding sudden cardiac risk in athletes, promoting comprehensive cardiac evaluations regardless of socioeconomic background, and advocating for equitable access to cardiac care. We implore athletes, sports organizations, medical professionals, and the wider community to unite in mitigating the risks associated with sports-related cardiac events, thereby ensuring the safety and well-being of all athletes.

Merije Chukumerije, MD; ABC member, Sports Cardiology specialist; Marlon E. Everett, MD, Co-Chair, ABC Communications Committee; Camille G. Frazier-Mills, MD, MHS, Co-Chair, ABC Electrophysiology Committee; Aubrey J. Grant, MD, ABC member, Sports Cardiology specialist; G. Mark Jenkins, MD, Co-Chair, ABC Advisory Group and Former ABC Board Member; Kevin F. Kwaku, MD, PhD, ABC Board Member and Co-Chair, ABC Electrophysiology Committee; Jayne Morgan, MD, Co-Chair, ABC Communications Committee; Anekwe E. Onwuanyi, MD, President of ABC; and Barbara Hutchinson, MD; ABC Board Chair.

About ABC
Founded in 1974, the ABC is a nonprofit organization dedicated to eliminating the disparities related to cardiovascular disease and achieving health equity such that all people can live long healthy lives. Membership is open to all interested in the care of people with or at risk for cardiovascular disease, including health professionals, lay members of the community (Community Health Advocates), corporate and institutional members. Today, the ABC's public and private partnerships continue to increase its impact in communities across the nation. For more information, visit www.abcardio.org and wearethefaces.abcardio.org or connect with ABC on Twitter, Facebook, Instagram, and LinkedIn.

Contact: ABC Media Relations
[email protected]
646-689-0659

SOURCE Association of Black Cardiologists