Volunteer heart experts at Johns Hopkins have embarked
on what is believed to be the largest
single-day event to date to screen young athletes in the
United States for early signs of life-
threatening defects in the body's blood-pumping organ.
The medics are scheduled to test the hearts of more
than 1,000 athletes, males and females
age 16 to 18, attending the 2008 track and field
championship games of the Maryland Public
Secondary Schools Athletic Association. The event is taking
place in Baltimore at Morgan State
University, at what the Johns Hopkins team has dubbed the
first-ever Heart Hype program.
According to Johns Hopkins cardiologist Theodore
Abraham, the stress of athletic competition
poses ultradangerous risks to those who have inherited
tendencies to develop overly enlarged and
thickened hearts, hypertrophic cardiomyopathies, or similar
abnormalities. These players have a
higher than normal risk of sudden, potentially fatal heart
rhythm disturbances or cardiac arrest.
"Too many young athletes are dying unnecessarily,"
Abraham said, referring to the several
thousand such sudden deaths per year, by some estimates, in
younger adults in the United States.
"The most frustrating thing is that so many athletes are
seemingly unaware about the consequences of
putting too much strain on their abnormal cardiac muscle
during vigorous exercise."
Many cases go undiagnosed, he says, because the
athletes' healthy appearance and peak physical
condition may mask their underlying sickness. Experts
estimate that one in 500 Americans has
undiagnosed hypertrophic cardiomyopathy; African-Americans
are most vulnerable, with two to three
times the rate of sudden cardiac death than in whites.
The Johns Hopkins team of more than 70 includes
cardiologists, medical residents, nurses,
ultrasound technicians, administrative assistants and
community volunteers. They will run a series of
heart tests from 10 a.m. to 4 p.m. on Saturday, May 24, on
athletes who volunteer to be checked in
Morgan State's Hurt Gymnasium.
The checkup will include a questionnaire to review any
past history of chest pain, shortness of
breath, fainting spells, instances of sudden cardiac death
in relatives, weight and blood pressure
measurements and tests for unusual heartbeats or murmurs.
Each athlete will receive a cardiac
ultrasound, or echocardiogram, to measure heart size and
its pumping function, including blood volume,
and to check for faulty valves. An electrocardiogram, or
EKG, to assess the heart's electrical rhythms
will also be given.
Test results will be reported to each athlete on site,
along with recommended follow-ups if
problems are detected.
"Young athletes and their parents should feel secure
in pursuing physical fitness to the best of
their children's abilities and without the unknown risk
from sudden cardiac death," said Abraham, an
associate professor at the School of Medicine and its
Heart Institute.
"Our goal is to make this not only an annual program
in Maryland but to serve as a model for
other programs to start across the country, state by state,
city by city, if necessary," he said, noting
that other countries, such as Italy and Japan, have since
the early 1980s run regular school programs
to screen teenage athletes and nonathletes for possible
heart problems. Health officials in one region
of Italy reported that screening had saved at least 22
lives.
The first documented case of sudden death dates back
to 490 B.C., to the Greek origins of
what is now the Olympic marathon, when Pheidippides
collapsed and died after announcing military
victory over the Persians.
In 2004, the International Olympic Committee
recommended that all athletes be EKG-tested
every two years for potential heart abnormalities. However,
the U.S. Olympic team does not require
physical exams for its competing athletes but instead
offers voluntary cardiac screening.
Risk reduction strategies to prevent cardiac arrest
include avoiding rigorous sports; taking
beta-blockers that temper the heartbeat, preventing it from
beating too fast; or implanting
defibrillators that can shock the heart back into normal
electrical rhythm.
Abraham says that in the last decade he has treated
dozens of athletes with overly enlarged
hearts whose vulnerable condition precluded any highly
strenuous activity. He cites the rising numbers
as what compelled him to organize the screening.
Among the most notable fatalities to date, he says,
was Baltimore native Reggie Lewis, 27, a
basketball player for the Boston Celtics, who in the summer
of 1993 dropped dead on the court from
cardiac arrest, likely triggered by an overly enlarged and
thickened heart. Lewis, a graduate of Dunbar
High School, was African-American. He had collapsed earlier
in the year and continued to play, not
fully aware that such an event weakens, inflames and
enlarges the heart muscle. In Lewis' honor, his
mother, Peggy Rich, has endorsed the Heart Hype event and
plans to speak at a reception being held
the night before.
Testing supplies for the event were donated by The
Johns Hopkins Hospital. Ultrasound and
EKG equipment was provided by General Electric Healthcare.
The use of GE equipment for this event
does not constitute or imply endorsement by Johns Hopkins
of GE products or services.
Other young athletes whose deaths were suspected or
reported to have been caused by sudden
cardiac arrest are Ryan Shay, 28, a top-ranked U.S.
marathon runner training for the Olympics, who
suffered from cardiac arrest partway through the 2007 New
York marathon; Damien Nash, 24, a
football player with the Denver Broncos, who died in 2007
of an undiagnosed heart problem after
playing in a charity game; Jason Collier, 28, an Atlanta
Hawks football player who died suddenly in
2005 during the off-season and while on route to hospital;
Thomas Herrion, 23, a San Francisco 49ers
football player who in 2005 collapsed in the locker room
after suffering what appeared to be a heart
stoppage; Ken Derminer, 17, who died suddenly in 2000
during college football practice; Chad Butrum,
26, a football player from Southern California who in 1994
died during a game; and Hank Gathers, 23,
a basketball player at Loyola Marymount University in Los
Angeles, who collapsed on the court from
cardiac arrest in 1990, dying in hospital shortly
thereafter.
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