**Sudden Cardiac Arrest in Schools: Protecting Youth Through Readiness and Policy**

Every year, sudden cardiac arrest (SCA) takes the lives of around 7,000 children and teenagers in the United States, ranking it among the top causes of mortality in youth. The sudden nature of SCA makes it particularly tragic, leaving schools, families, and communities to cope with tremendous grief. Student-athletes face an increased risk because of the physical demands of sports, but all students are at risk—SCA can affect anyone. This highlights the urgent necessity for schools to be prepared and trained to respond effectively to cardiac emergencies. Recent legislative measures, along with improved preparedness and equitable funding, are significant steps toward tackling this pressing public health concern.

### Comprehending SCA and Its Effects

SCA happens when the heart unexpectedly ceases to beat, stopping blood circulation to the brain and other essential organs. Unlike a heart attack, which is a blockage issue, SCA represents a malfunction in the heart’s electrical system. Untreated, SCA is nearly always fatal. For young individuals, vigorous sports like basketball, football, and soccer pose increased SCA risks, making it a top cause of death among student-athletes, especially males. Nevertheless, it frequently affects those outside sports, often due to previously undetected heart issues.

The urgency of SCA response emphasizes the necessity for quick action. Without immediate resuscitation efforts such as cardiopulmonary resuscitation (CPR) or the use of an automated external defibrillator (AED), survival rates for out-of-hospital SCA incidents are lower than 10 percent. Studies indicate that starting CPR can double or triple the chances of survival, and employing AEDs within 3 to 5 minutes can elevate survival rates to between 40 and 70 percent. However, for every minute defibrillation is postponed, survival rates drop by 7 to 10 percent, underscoring the importance of readiness for saving lives.

### The HEARTS Act: A Bipartisan Legislative Achievement

In response to the pressing need for systemic readiness, the Cardiomyopathy Health Education, Awareness, Research, and Training in Schools (HEARTS) Act was introduced by Congressman Frank Pallone (D-NJ) and enacted in December 2024. This crucial federal legislation aims to confront SCA in youth through a comprehensive strategy.

The HEARTS Act initiates a federal grant program to support AED procurement for schools across the nation and provides resources for CPR and AED training for students, staff, and faculty. The Act specifically calls for schools to formulate and execute extensive cardiac emergency response plans (CERPs) detailing necessary steps in the event of an SCA, encompassing training personnel, maintaining AEDs, and enhancing response cooperation with local emergency services.

Raising public awareness about conditions that elevate SCA risk, such as cardiomyopathy, is another essential aspect of the Act, which seeks to equip schools with the information and tools needed to avert tragedies. Crucially, the HEARTS Act mandates fair implementation in under-resourced school districts to tackle disparities in cardiac readiness.

The legislation has already made a significant impact, inspired by notable SCA cases such as the highly publicized cardiac arrest of NFL player Damar Hamlin in January 2023. The HEARTS Act marks a long-overdue advancement, creating a framework to safeguard young lives while fostering a culture of health and safety in schools and communities.

### Financial Inequities in Implementation

While the HEARTS Act provides a transformative strategy for change, actual implementation encounters challenges, especially in underfunded school districts. A 2024 report on K-12 financing reveals persistent budgetary inequalities among U.S. schools, with many states investing less in education compared to their economic capabilities since 2006. Low-income schools serving African American and Hispanic students are particularly impacted, often lacking access to essential resources like AEDs or CPR training programs.

These inequities present a significant risk: affluent districts are well-prepared to meet HEARTS Act requirements, while underfunded schools may struggle in the absence of additional resources. It is vital for federal funding to prioritize high-poverty and underserved areas, ensuring every school—and consequently all students—are equally equipped for cardiac emergencies.

Innovative solutions should be pursued to improve preparedness and mitigate funding disparities. For instance, incorporating CPR and AED training into health or physical education courses guarantees universal exposure, while virtual training programs can broaden access in rural or underfunded areas. Collaboration with organizations such as the American Heart Association, local health departments, and businesses can also provide additional resources.

### Fostering a Culture of Readiness

One of the HEARTS Act’s most impactful implications is its commitment to impart life-saving skills to students. Schools are central to daily life for nearly 20 percent of the U.S. population