SIOUX FALLS, S.D. (Dakota News Now) – Cole Peterson is 18 years old, in prime physical shape, and in three weeks, the recent Sioux Falls Washington High School graduate is leaving for Hamline University in St. Paul, Minn., where he will play basketball.

Until just over a week ago, he had never even thought of the possibility of suffering a heart attack on the court.

But it is definitely on the longtime Sanford Sports Academy player’s radar since he heard about the cardiac arrest of University of Southern California freshman Bronny James on July 24.

“It’s surprising,” Peterson said. “Cardiac arrest is really rare for a young person. Plus, Bronny James is like the healthiest person around. His dad is LeBron James and he’s had probably chef-cooked meals his whole life.”

Though uncommon, sudden cardiac arrest is the most common cause of natural death in young athletes, affecting anywhere from 1 in 15,000 or 1 in 50,000 depending on the medical study, according to Dr. Dermot Phelan, director of sports cardiology at Atrium Health in Charlotte, N.C.

James’ event is the second to happen to a high-profile athlete in the last seven months. Buffalo Bills safety Damar Hamlin experienced a heart attack during a nationally-televised NFL Monday Night Football game in January.

Why this happens to a group of people that are seemingly at such low risk for a heart emergency is still a mystery, said Sanford Heart Hospital cardiologist Dr. Nerveen Rajpurohit.

“Unfortunately, there is a lot we do not know about these conditions,” Rajpurohit told Dakota News Now. “There’s a lot of research going on, and unfortunately, a lot of these (cases) go undetected, and even in autopsy reports, a lot of these patients have a normal heart. Usually, it’ an electronic issue or there’s a genetic channelopathy, which is not always easily identified.”

It is unknown publicly what caused James’ heart to stop. What is known is the swift and effective response by the USC medical staff helped save James’ life after he had collapsed and lost consciousness, according to his cardiologist.

“He arrived at Cedars-Sinai Medical Center fully conscious, neurologically intact and stable,” Dr. Merije Chukumerije said.

The incident, and the way trainers and medical staff handled James “just reinforces what we do as an athletic training staff at Sanford in being prepared,” said Sanford athletic training manager Sean Duffy.

”We’re always encouraged to see that, because it gives us momentum to implement more change. More protocols. More protection for our student athletes.”

Beyond trainers, coaches in sports sanctioned by the South Dakota High School Activities Association are now required to take courses in how to handle athletes who collapse, said Dan Swartos, the SDHSAA executive director.

Swartos said most, if not all schools in South Dakota have an AED defibrillator device available in case someone goes through cardiac arrest. Those devices are becoming more prevalent in all public places like airports, churches, and hospitals. The AED helps bring back the patient’s heartbeat.

“You don’t need to be a trained medical professional to use an AED,” Duffy said. “Hook it up, and it tells you what to do, and that’s the important thing to reinforce to the community and people who don’t feel comfortable with acting in an emergency situation.

It has been at least five years since a high school athlete in South Dakota suffered cardiac arrest while practicing or competing, Swartos said. More common is a coach or official having a heart attack, by nature of their age and level of physical fitness, Duffy said.

Dr. Rajpurohit said some cardiac arrest victims don’t show any symptoms, but typical signs for the athlete and anyone near them are chest pain, light-headedness, and dizziness, and abnormal heart palpitations.

Peterson said he has experienced dizziness while playing basketball before, usually if he has been working out for well over an hour and started on an empty stomach. He’ll monitor that sort of thing more closely.

There are ways to detect possible underlying heart problems before a cardiac arrest happens, but that requires the work of a physician, Dr. Rajpurohit said.

“There are a lot of genetic conditions, inherited conditions which might be passed in their family,” Dr. Rejpurohit said. He recommends that if you know of a family history of heart health problems to have a medical screening to identify if you have any.

Both Dr. Rajpurohit and Duffy recommended parents making sure their young athletes receive a physical exam from a family physician before a season starts.

Duffy said that as high school fall sports teams like football and soccer squads report to training camp in the coming days, it is important for teams’ trainers and coaches to be aware of any underlying heart condition any athlete has — which is why a doctor’s exam is so crucial.

Peterson has never had a heart condition. But after learning of the Bronny James episode, the fellow healthy 18-year-old is now focused on reducing his chances of a heart attack with some good old fashioned “healthy lifestyle” safeguards that medical experts have always recommended for people of all ages in order to prevent heart disease — a catalyst of cardiac arrests and the leading cause of death among all American adults.

“I realize that it’s really rare,” Peterson said. “It’s, like, a really small chance of it happening, but it did happen to (James), so I’m going to take that and just be as smart as a I can. Do the little things like get the right sleep and drink enough water, eat the right food. Doing these things will make me more healthy, in general.”