Heart screening key to avoiding sudden deaths in athletes
We have always believed that athletic individuals possess a stronger heart and have “clearer” arteries that allow blood to flow more easily throughout their body.
Which is why it is quite puzzling to hear news of individuals suddenly collapsing and even succumbing to sudden death afterward as a result of a heart failure.
Well-known athletes who have experienced this include Boston Celtics captain Reggie Lewis who died of cardiac arrest in 1993 while shooting baskets. He was only 27.
In the United States, researchers say that at least 14 people have died in triathlons between 2006 and 2008. This means having a sudden death rate of 1.5 deaths per 100,000 participants, double the rate associated with marathons that have 0.8 deaths per 100,000 (the study involved USA Triathlon-sanctioned events involving a total of 959,214 participants).
These tragedies are refueling the debate and controversy over whether all athletes as well as other physically active individuals should be getting a mandatory electrocardiogram (ECG) to screen them for heart disease.
Alert the doctor
According to Foundation for Lay Education on Heart Diseases founder and chair Dr. Adolfo Bellosillo, undergoing an ECG test may alert the doctor of hidden heart defects or overlooked heart abnormalities that could trigger cases of sudden death.
“The most common cause of sudden death among active or athletic individuals is hypertrophic cardiomyopathy, that is, when the heart is thickened and enlarged. This problem can be detected by an initial ECG screening, and if the doctor suspects something, should be followed by an echocardiogram (an ultrasound of the heart) for diagnosis,” Bellosillo said.
Another serious but rarer condition among young people is dilated cardiomyopathy, in which the heart is enlarged but the walls are thin.
Bellosillo added that sometimes an individual is born with heart arteries that are connected abnormally and could become compressed during exercise inhibiting proper blood flow to the heart that could lead to cardiac arrest.
Most of these congenital abnormalities of the heart are asymptomatic, making it a silent killer.
In fact, sudden death during exercise is the first sign of these conditions, which worries Bellosillo.
“Adding ECG to the current standard of care may be able to improve the ability of doctors to detect underlying heart diseases that a medical history and examination may miss,” Bellosillo reiterated.
However, cardiologists also reminded that an ECG has its limitations and that a major concern with relying too much on this procedure is false positives, that is, the test says there’s something wrong when there is not.
Such misidentification of a healthy heart as damaged may unnecessarily encourage young athletes to give up the sports they love.
Important symptoms
Nevertheless, doctors reminded family members and friends to watch out for these important symptoms:
Unexplained fainting that occurs during physical activity. This may be a sign that there’s a problem with the athlete’s heart.
Family history of sudden cardiac death. The other major warning sign is a family history of unexplained deaths before the age of 50. Deaths like this in one’s family should prompt one to pay close attention and perhaps talk with a doctor about screening options.
Shortness of breath or chest pain. While these two may be a sign of other health problems, such as asthma, one should be alerted that this may also be a sign that one is at risk of sudden cardiac death.
Bellosillo reminded that if you are at risk of sudden cardiac death, talk to your cardiologist about your physical activity level or if you could participate in exercise or sports.
“Talk to your doctor about what sort of activities and behaviors you should avoid because this does not mean that you will need to avoid exercise altogether,” Bellosillo said.
