One thing Lucas Seehafer always tells his students is that the body is good at telling you something is wrong, but not always good at telling you where. Seehafer, a physical therapist with the Mayo Clinic and professor of exercise science at Bethany Lutheran College Minnesota, knows that nerve overlap throughout the body can make it difficult for athletes to pinpoint the source of their symptoms. One place where this phenomenon manifests in particular is the heart.

The heart is the vital organ for life. While the majority of college athletes are extraordinarily healthy and unlikely to experience a cardiac event, Seehafer emphasizes the importance of knowing the symptoms.

“Just because you’re young doesn't mean you can’t have heart conditions,” says Seehafer.

The overall incidence of sudden cardiac death has decreased in NCAA sports over the past 20 years, but according to the National Institutes of Health, it remains the leading cause of non-accidental death in this population. The vast majority of college athletes will never experience a cardiac event; those who have, however, understand how important it is to recognize the warning signs. Hailey Yentz, a distance runner at Eastern Carolina University, unexpectedly collapsed during a workout. The culprit? Sudden cardiac arrest. Yentz went without a pulse for 10 minutes. She was saved by a team of first responders performing CPR and activating an AED (Automated External Defibrillator), which sends an electrical shock to the chest to get the heart beating again.

Yantz was ultimately diagnosed with a condition called arrhythmogenic right ventricular cardiomyopathy (ARVC), which weakens the heart muscles. It’s a genetic condition that can be exacerbated by intense exercise, but often goes undetected because the heart usually looks normal and symptoms may be subtle.

And it’s normal for these types of genetic, asymptomatic conditions to go undetected, as well as hypertrophic cardio myopathy, the big heart condition that sports doctors are often looking for.

“It’s a fancy way of saying the heart is abnormally large,” Seehafer explained. “A lot of the time individuals who have that are asymptomatic unless they’ve done some sort of cardio imaging in the past.” Other cardiomyopathies, like fibrillation (an irregular heart beat) can also be present in college athletes.

While the likelihood of heart issues differs between male and female athletes, Seehafer still stresses not to get caught up in gender myths.

“Men’s hearts tend to be larger, because men tend to be larger,” Seehafer explained, “ Instances of cardiomyopathy or some sort of heart disease are more common in men than women.”

Seehafer emphasizes, however, that gender has little to do with whether or not an athlete has a heart condition. Rather, it has lots to do with how heart issues are presented. For example, a widely-known symptom of a heart attack is pain in one’s left arm.

This phenomenon, however, is presented far more in men than women, who are more likely to experience neck pain, which is not as widely associated with cardiac events. Therefore, women are more likely to ignore their symptoms.

Like left arm pain, there are other more universal predictors of heart health issues, like high blood pressure. Seehafer also encourages athletes to pay attention to symptoms that can be associated with anxiety, like a fluttering heart. If it’s racing at a steady rate, it’s probably anxiety; if it’s racing unpredictably, it could potentially be the sign of something more serious, like an atrial fibrillation.

Some athletes, but not all, undergo screenings for heart health through their college programs. At Division I schools, athletes are more likely to receive a heart health screening, as many of those schools have doctors on staff. Schools like the University of Wisconsin and the University of Michigan even have entire sports medicine departments on staff.

Less affluent D1 schools, D2, and D3 schools, however, often only provide concussion texting and some level of orthopedic screening for their athletes. If an athlete at one of those programs is concerned about their health, the responsibility will likely fall on them to acquire the appropriate screening.

However, athletic programs have emergency protocols in place in the case that a cardiac event does happen. Most athletic events will have an AED on site, and athletic trainers, who train yearly on AEDs and CPR, know where the machine is and how to use it. At Eastern Carolina University, the AED and the staff’s ability to quickly use it is why Hailey Yentz survived her cardiac arrest.

“If there was no AED, then I probably would not be here today,” Yentz said to WJLA.

At the college level, the vast majority of athletes will not experience heart problems. Athletes exercise regularly, eat well and generally know how to take care of themselves. But it’s always good to know the symptoms, and as Seehafer emphasized, it’s better to be over-cautious. If your body is trying to tell you something is wrong, it’s never a bad idea to stop and listen.