It seems all too often that we hear tragic stories of young athletes collapsing unexpectedly on the field or court. Although these cases are actually relatively rare, we as parents often wonder how this can happen. How does a young, otherwise healthy student die suddenly without any warning signs?
As a cardiologist and a parent, these stories particularly resonate with me. Especially knowing, like most things in cardiology, that these deaths can be prevented with early detection.
Hypertrophic Cardiomyopathy (HCM) is the leading cause of sudden cardiac death in young, otherwise healthy student athletes. It can affect up to one in every 500 student athletes. It’s characterized by an abnormal thickening of the heart that can predispose the individual to many different problems including fainting spells. More importantly, it can lead to dangerous heart rhythms originating in the bottom chambers of the heart. If these rhythms do not self terminate, or if a bystander does not perform cardiopulmonary resuscitation (CPR), or access an automatic external defibrillator (AED) in a timely fashion, it will often lead to death. Did I mention this can be prevented?
Mike and Eva Collins—who live in Georgetown, Texas—know about the serious nature of HCM all too well. One afternoon, their son Joseph collapsed on the baseball field during a routine practice. He was rushed to the hospital and remained in a coma for five days. Fortunately, Joseph survived. He was diagnosed with HCM. Doctors subsequently implanted a defibrillator to help protect him from future similar events. Joseph now enjoys excellent health, and his parents continue to share his story with others to increase awareness of this life-threatening condition.
Like Joseph, many people with HCM have no warning signs—often times the first symptom is sudden cardiac death. As a result, a traditional pre-sports history and physical can miss HCM. Even the most detailed history taking will not reveal a disorder that is not causing symptoms. The murmur that is associated with HCM can be dynamic and subtle—all too often going under appreciated by the performing physician. The best way to detect HCM is an echocardiogram. Unfortunately, due to cost constraints, this testing is not routinely used as part of a pre-sports physical across the United States.
Twice a year, the Heart Hospital of Austin, an affiliate of HCA, offers free heart screenings for student athletes ages 14 to 18. The screening includes a 12-lead electrocardiograph (ECG) and a limited two-dimensional echocardiogram, or ultrasound of the heart, to help potentially detect this dangerous disorder. During each screening, a cardiologist interprets the tests and reviews the results with the student and his or her family. To date, the Heart Hospital of Austin has screened nearly 7,000 student athletes.
As you secure your son or daughter’s safety gear for their sport of choice, I urge you to protect them in a way sports gear cannot—get informed and have them screened for HCM.
Vivek Goswami, M.D., is a clinical cardiologist who practices at the Heart Hospital of Austin.