Announcement
Sudden Cardiac Death in Athletes - Why Take The Chance? from the Wall Street Journal and DW
Posted by Donald Wilkerson on
Jun 23 2005
at
05:00PM PDT
SUDDEN CARDIAC DEATH IN ATHLETES – WHY TAKE THE CHANCE?
(Excerpt from the WALL STREET JOURNAL with comments added by D. Wilkerson( (This article was posted in June 2005)
From time to time we hear of a high school athlete who suddenly dies on the playing field or in the gym. Young athletes suffer sudden cardiac death at a rate thought to be two to three times as high as their less-active peers. Often the cause is hypertropic cardiomyopathy. HCM, as it is called for short, is a rare genetic abnormality that enlarges the left ventricle of the heart leading to sometimes fatal disturbances of the heart rhythm.
Few doctors in the United States suggest a young athlete undergo a heart scan which is required to detect the abnormality (HCM is a hidden heart defect that is not detected with a stethoscope). American medicine, despite being respected around the world for its all-out war on heart disease, does relatively little to detect problems or raise awareness of hidden congenital defects that suddenly kill young athletes. In American medicine, it is generally accepted that universal screening of young adults for heart abnormalities wouldn't be a good idea. Far too many healthy athletes would have to be screened to find a single defective heart, cardiologists say. U. S. cardiologists, instead of wide spread screening, favor efforts to raise awareness about the symptoms and risk factors, leading to testing of those at risk. They favor a focus on kids who have cardiac murmurs, fainting spells, chest pain, or shortness of breath, plus any who have had sudden cardiac death in their families. A simple inexpensive electrocardiogram (EKG) will flag most, but not all, cases of HCM. A new portable echocardiogram that cardiologists say is surprisingly effective is available today for under $60 and often as little as $35. A comprehensive echocardiogram that is excellent in detecting not only HCM but various other abnormalities costs around $900.
Little has been done to raise awareness of HCM among either front line physicians or the general public. One possible reason: Sudden death in adolescents falls outside the primary mission both of pediatric cardiologists, who treat children, and of adult cardiologists, who focus on the middle-aged and older. In cardiology, adolescence and young adulthood is a "no-man's land" says Robert Myerburg, director of cardiology at the University of Miami School of Medicine.
In Japan doctors routinely give school children electrocardiograms, or EKGs, which can detect congenital heart defects that a stethoscope cannot. Italy gives EKGs to all youths who want to participate in competitive sports. The International Olympic Committee recently recommended that young athletes have EKGs every two years.
When a young athlete dies suddenly, local news outlets typically seek comment from doctors, who typically fail to mention that the main cause is detectable by an EKG. After reviewing dozens of applicable news stories, it seems that doctors who were quoted almost never mentioned that fact, the ability to treat HCM, or the common warning signs!
It appears that many doctors underestimate the frequency of sudden cardiac deaths in young athletes. No government agency keeps count. But Dr. Barry Maron, a Minneapolis cardiologist who is one of the world’s leading authorities on HCM, has been compiling news reports for a registry. So far, he says his count suggests there are between 200 and 300 sudden deaths in young athletes per year in the U.S. Most doctors are likely to say there are 100 or fewer. Some physicians cite the National Federation of High School Associations as saying there are only 10 and 25 per year. The federation says it has never characterized its statistics as complete. An even lower figure comes from the American Academy of Pediatrics whose members do many pre-participation sports physicals. The academy says on its web site that only 10 to 13 such sudden deaths are reported each year. Their source, the National Center for Catastrophic Sport Injury Research at the University of North Carolina says that 10 to 13 figure is too low and does not know where those numbers came from. The danger of understated numbers is that doctors think this isn’t something to worry about:”The wrong numbers have been very destructive”.
Without belaboring the point, regardless of whether your school’s pre-participation forms have several heart-related questions (most do not) or whether your cardiologist fails to appreciate shortness of breath or familial risk (many do not), there are steps you as a parent of an athlete can take to safeguard your child’s well being.
The steps required to address this problem include:
1. Get your child an EKG prior to participation (and a simple inexpensive echocardiogram).
2. Increase awareness by talking with your friends and parents of other athletes.
3. Encourage your school system to place defibrillators in the high schools and have qualified personnel trained on their use available.
4. Support the organization of clinics to provide free or low cost screening scans and encourage usage of the clinics. Turnout at these clinics nationally is dismally low probably due to lack of awareness.
With a few simple, inexpensive steps, responsible parents can possibly avoid the loss of one or more of their children. If mass screenings ever become the norm, the beneficiaries would not just be the occasional kid who’s found to have a cardiac defect and his or her siblings and parents (since HCM often runs in families), it would include scanning equipment makers and cardiologists to whom abnormal scans would be referred. Not to mention the spectators, teammates and coaches who would be spared from watching someone die needlessly.
Most of this article is an excerpt from The Wall Street Journal, Thursday, June 23, 2005.
(Excerpt from the WALL STREET JOURNAL with comments added by D. Wilkerson( (This article was posted in June 2005)
From time to time we hear of a high school athlete who suddenly dies on the playing field or in the gym. Young athletes suffer sudden cardiac death at a rate thought to be two to three times as high as their less-active peers. Often the cause is hypertropic cardiomyopathy. HCM, as it is called for short, is a rare genetic abnormality that enlarges the left ventricle of the heart leading to sometimes fatal disturbances of the heart rhythm.
Few doctors in the United States suggest a young athlete undergo a heart scan which is required to detect the abnormality (HCM is a hidden heart defect that is not detected with a stethoscope). American medicine, despite being respected around the world for its all-out war on heart disease, does relatively little to detect problems or raise awareness of hidden congenital defects that suddenly kill young athletes. In American medicine, it is generally accepted that universal screening of young adults for heart abnormalities wouldn't be a good idea. Far too many healthy athletes would have to be screened to find a single defective heart, cardiologists say. U. S. cardiologists, instead of wide spread screening, favor efforts to raise awareness about the symptoms and risk factors, leading to testing of those at risk. They favor a focus on kids who have cardiac murmurs, fainting spells, chest pain, or shortness of breath, plus any who have had sudden cardiac death in their families. A simple inexpensive electrocardiogram (EKG) will flag most, but not all, cases of HCM. A new portable echocardiogram that cardiologists say is surprisingly effective is available today for under $60 and often as little as $35. A comprehensive echocardiogram that is excellent in detecting not only HCM but various other abnormalities costs around $900.
Little has been done to raise awareness of HCM among either front line physicians or the general public. One possible reason: Sudden death in adolescents falls outside the primary mission both of pediatric cardiologists, who treat children, and of adult cardiologists, who focus on the middle-aged and older. In cardiology, adolescence and young adulthood is a "no-man's land" says Robert Myerburg, director of cardiology at the University of Miami School of Medicine.
In Japan doctors routinely give school children electrocardiograms, or EKGs, which can detect congenital heart defects that a stethoscope cannot. Italy gives EKGs to all youths who want to participate in competitive sports. The International Olympic Committee recently recommended that young athletes have EKGs every two years.
When a young athlete dies suddenly, local news outlets typically seek comment from doctors, who typically fail to mention that the main cause is detectable by an EKG. After reviewing dozens of applicable news stories, it seems that doctors who were quoted almost never mentioned that fact, the ability to treat HCM, or the common warning signs!
It appears that many doctors underestimate the frequency of sudden cardiac deaths in young athletes. No government agency keeps count. But Dr. Barry Maron, a Minneapolis cardiologist who is one of the world’s leading authorities on HCM, has been compiling news reports for a registry. So far, he says his count suggests there are between 200 and 300 sudden deaths in young athletes per year in the U.S. Most doctors are likely to say there are 100 or fewer. Some physicians cite the National Federation of High School Associations as saying there are only 10 and 25 per year. The federation says it has never characterized its statistics as complete. An even lower figure comes from the American Academy of Pediatrics whose members do many pre-participation sports physicals. The academy says on its web site that only 10 to 13 such sudden deaths are reported each year. Their source, the National Center for Catastrophic Sport Injury Research at the University of North Carolina says that 10 to 13 figure is too low and does not know where those numbers came from. The danger of understated numbers is that doctors think this isn’t something to worry about:”The wrong numbers have been very destructive”.
Without belaboring the point, regardless of whether your school’s pre-participation forms have several heart-related questions (most do not) or whether your cardiologist fails to appreciate shortness of breath or familial risk (many do not), there are steps you as a parent of an athlete can take to safeguard your child’s well being.
The steps required to address this problem include:
1. Get your child an EKG prior to participation (and a simple inexpensive echocardiogram).
2. Increase awareness by talking with your friends and parents of other athletes.
3. Encourage your school system to place defibrillators in the high schools and have qualified personnel trained on their use available.
4. Support the organization of clinics to provide free or low cost screening scans and encourage usage of the clinics. Turnout at these clinics nationally is dismally low probably due to lack of awareness.
With a few simple, inexpensive steps, responsible parents can possibly avoid the loss of one or more of their children. If mass screenings ever become the norm, the beneficiaries would not just be the occasional kid who’s found to have a cardiac defect and his or her siblings and parents (since HCM often runs in families), it would include scanning equipment makers and cardiologists to whom abnormal scans would be referred. Not to mention the spectators, teammates and coaches who would be spared from watching someone die needlessly.
Most of this article is an excerpt from The Wall Street Journal, Thursday, June 23, 2005.
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