The scenarios that could have led to Bronny James’ cardiac arrest scare

The sports world was stunned to learn on Tuesday morning that Bronny James suffered cardiac arrest while practicing basketball at USC on Monday.

To learn about what might have caused the incident, The Post reached out to Dr. Marc Cohen, , whoꦰ has n👍ot examined James.

NY Post: What are the possible factors that could cause a healthy 18-year-old athlete to have a cardiac arrest?

Dr. Marc Cohen: The heart has two major coronary arteries — the right coronary artery and the left main coronary artery. Those arteries come off at certain angles of the large blood vessel called the aorta.

If you’re born with those arteries coming off in unusual places, they may not manifest any problem for years, and then as you get older it’s possible that during a larger amount of exertion the different origin of that coronary artery can result in a restriction of the amount of blood that flows to that artery.

So, the first way that tꦛhis could happen is if he was born with an Anomalous Coronary Artery. That could trigger a sudden cardiac event.

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There are some patients for whom this is a problem from birth, and then there are others who survive to 15 or 18 or maybe 30 or 40, and then at an older🥃 age it causes trouble.

This could be that Bronny was born with a congenital condition that didn’t manifest at birth, but did later in life.

The second possibility is that he had what is called an underlying cardiomyopathy. That means that his heart muscle may have some kind of scar tissue, and there are different reasons why scar tissue can develop in the heart. That scar tissue might have triggered an arrhythmia — an irregular heart rhythm.

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For example, he could have sarcoid cardiomyopathy. He could have been born with a little bit of a cardiomyopathy that he could have managed with, and as he got older and bigger and heavier and did some heavy-duty exercise or working out, that could have precipitated the༺ scar tissue to trigger an irregular rhythm.

And then there’s another thing that could have been possible here. Cardiomyopathy usually affects the left ventricle, but there are some cardiac diseases that affect the right ventricle, such as Right Ventricular Dysplasia.

The fancy word for this would be Uhl’s Anomaly, and that also doesn’t necessarily manifest early — it could come later in life.

What is next for Bronny in terms of recovery, and what is the path for him to return to the basketball court?

The short answer is, when they come up with a mechanism for why he had the cardiac arrest, you could then and only then make an informed decision rega🧔rding his recovery and his ability to go back on the court.

You remember Damar Hamlin. There was basically nothing wrong with his heart. He just managed to get his heart bashed in by that interaction with the opposing player. There was a very clear trigger there. It didn’t have to do with any kind of problem with his heart, so medically if you avoid that kind of direct impact on the heart you would theoretically be able to say, “OK, as long as you avoid that you should be fine.”

We need to learn the details of what happened to Mr. LeBron James’ son, in terms of what was the rhythm that they saw when they brought him back to life.

What did the echocardiogram show in terms of his heart’s function? Did he have those things that I mentioned to you before like a coronary anomaly and/or a cardiomyopathy?

The answers to these questions completely revolves around what caused the event, and therefore until we get some wind of what caused the event we really wouldn’t be able to say in an informed manner what his future would be like.

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Have you seen an uptick in cardiac incidents in relative youths in recent years?

I don’t know if that’s the case.

What I have for sure witnessed is an increase in childhood and adoleജscent obesity, and elevations in blood pressure and hypertension.

I’m not a pediatrician. I’m an adult cardiologist. I don’t honestly think I’ve heard about an increase in incidents in cardiac arrests [for youths].

Do you think it’s possible that Covid-19 vaccines have had any linkage to cardiac incidents?

I can tell you that the statistical analyses that have been done, in gazillions of patients t🧸hat have been vaccinate💯d, do not support a significant increase in what I would call malignant ventricular arrhythmia.

Do you think stimulant usage, such as energy drinks and ADHD/ADD medications, could have linkage in cardiac events? [Note: This question was posed in general, not specifically to Bronny.]

We know for a fact that energy drinks do function by being a mimic for adrenaline. We know for a fact that too much adrenaline causes your heart to freak out. It causes your heart to devꦰelop abnormal heart rhythms, rapid heart rhythms and, sometim﷽es in susceptible individuals, malignant rhythms that can cause you to collapse.

ADD/ADHD medications, to sꦐome extent, mimic the eff🍒ects of adrenaline.

If someone has ADHD and is always moving around and hyperkinetic, it is interesting that instead of drugs that slow you down, like sedatives, these children and young adults, in my opinion a little counterintuitively, benefit from these agents — at least the effects of these agents on the brain.

However, it needs to be noted that these agents on the rest of your body, like your heart and blood vessels, do cause your blood pressure to go up and do potentially cause 💯your heart rate to increase. And so, while it has a beneficial effect on patients with ADD with regard to the effect on the brain, they clearly do have effects on the heart and vessels of the body that are not ideal.

Between the energy drinks and the 🍌more frequent use of ADHD-type drugs, I💖 think those are very legitimate areas of concern as possible contributors to some kind of bad event relating to the heart.

This interview has been edited for clarity.