Having the heart for sport?

One moment: a perfect shot to end a perfect season. The star player, just 16, lifted off the floor in celebration.  Teenagers triumphant, crowds cheering, the playoffs ahead and his future wide open. The next: Wes Leonard was on the gym floor, his enlarged heart failing and his life fading as paramedics struggled in vain to revive him.

Then there was Matthew Hammerdorfer, 17 and captain of his high school rugby team. During a match Saturday, he took a hit to the chest, collapsed and died.

Sudden death in an athlete inevitably stirs public concern as well as front-page headlines.   As healthcare professionals, we question what more could have been done? Parents wonder if this could happen to their child. Some may even ask whether the benefits of sport are worth the risk.

While Leonard and Hammerdorfer’s friends, family, team-mates and coaches struggle to come to terms with their untimely passing, doctors at the University of Michigan Cardiovascular Center are helping to explain what happened. Non-traumatic sudden death in young athletes is always disturbing. Fortunately, it is also extremely rare.  It most commonly occurs in males, who have estimated death rates nearly 5-fold greater than female athletes.

According to the National Center for Catastrophic Sports Injury Research, the incidence of non-traumatic sudden seath in athletes is as follows: 

Population group                                                            Age                                                              Incidence

High school/college athletes                                           13-23                                                    7:1,000,000 per year (male)

U.S. Air Force recruits                                                       17 -28 years                                       1:735,000 per year

Rhode Island joggers                                                          <30 years                                            1:280,000 per year

Rhode Island joggers                                                            30 -65 years                                      1:7,620 per year

Marathon runners                                                                Mean 37 years                                   1:50,000 race finishers

Congenital cardiovascular disease is the leading cause of non-traumatic athletic death, with hypertrophic cardiomyopathy being the most common cause. Hypertrophic cardiomyopathy is a genetic disease which results in thickening of the heart muscle. It is the leading cause of sudden death in children and adults and accounts for 40% of all athletics-related deaths. While it is estimated to affect 1:500 Americans, the onset and severity varies. Although some people experience  signs and symptoms, such as shortness of breath, chest pain, dizziness, lightheadedness, fainting or palpitations, in others, such as Leonard, the first symptom may be cardiac arrest or sudden cardiac death.

In Hammerdorfer’s case, the cause of death has been attributed to a complex congenital heart defect known as Tetralogy of Fallot.

Other causes of sudden cardiac death in athletes include:

Even though  deaths in young athletes are rare, each one is one too many.  So what can be done?  Doctors are now suggesting that schools improve their pre-participation sports screening forms and refer selected children for electrocardiograms (ECG’s) and additional screening.

In the meantime SRxA’s Word on Health sends our condolences to the families of all those who have lost loved ones from sudden cardiac death.

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