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The athlete and sudden death
Published: Friday | December 5, 2008
William Foster, Contributor
During the 1984 Olympics in Los Angeles, the United States won a silver medal in the women's volleyball competition. China took the gold. The captain of the United States' team was a statuesque young woman who had led the team in beating China earlier in the competition.
Less than two years later, in January 1986, after being substituted in a basketball game in Japan, Flo Hyman slid off the bench to sudden death. An autopsy revealed the African-American had ruptured her aorta. She was 32 years old.
Several weeks ago, a national swimmer still attending high school collapsed and died. Not long ago, it was reported that a player in the Manning Cup competition died suddenly. At a junior high school in Kingston 8, a youngster suffered an untimely death while training.
Unexpected finality
The common thread running through these sudden deaths was the unexpected finality. There was no warning, or none was recognised.
What was missing? It is hard to know after the fact. What is known? The most common cause of sudden death in young athletes is hypertrophic cardiomyopathy, an abnormal thickening of heart muscle that is usually caused by a defect in one of the proteins responsible for the contraction of the heart.
Family history is important. If a family member has died suddenly, especially under the age of 40, there is reason to check the survivors if the necropsy points to a hypertrophic cardiomyopathy.
Recognition
The next most common is Marfan syndrome. In these athletes, a building block is missing. Each time the heart beats, the aorta stretches. As many as 50 per cent of these young people are dead by age 32. The aorta has become too weak to withstand the stretch, some 110,000 times a day in the average beating heart. One may rest if tired, but the heart has to carry on. It was this that the silver medallist Flo Hyman had, unaware she was vulnerable.
It is the tall, near-sighted athlete who has the most common physical appearance: slim, gangly, with long arms, legs and fingers. Though I have patients like the silver medallist who are well-built, carrying the diagnosis, all are vulnerable to a brief flurry.
Of course, there are those afflicted whose illnesses are self-inflicted; due to drug use. Cocaine may cause chest pain. It may lead to a heart attack. This pain may also herald the same illness from which Flo Hyman died: a rupture of the aorta; in her case inherited, in others, self-inflicted.
An echocardiogram can, in five minutes, indicate whether one has either condition. To be sure, there are other conditions that may precipitate death. Prevailing culture is one. Unusual heart rhythms are another. Both can be managed. They only require willpower.
Premature death
Other circumstances leading to sudden death do occur, such as sinus of Valsalva aneurysms or coronary artery anomalies. The American, Pete Maravich, an NBA legend, had an unusual link-up of the arteries supplying his heart with blood. This malformation was diagnosed as the cause of his premature death.
How does one get an echocardiogram, a test that requires no needles? Ask your school to refer you to a hospital or other medical faci-lity that administers the test.
A sunset, purple in majesty or clothed in amber streaks, may take your breath away. Heavy clouds, pregnant with a simmering illness may also take your breath away, albeit prematurely. Today, you have the opportunity to choose.
William A.A. Foster is a consultant cardiologist. Email feedback to columns@gleanerjm.com or waafoster@hotmail.com.
Symptoms of hypertrophic cardiomyopathy
Fainting.
Blackouts.
Racing of the heart or an irregular heart rhythm.
Shortness of breath.
'The aorta has become too weak to withstand the stretch, some 110,000 times a day in the average beating heart'.
Published: Friday | December 5, 2008
William Foster, Contributor
During the 1984 Olympics in Los Angeles, the United States won a silver medal in the women's volleyball competition. China took the gold. The captain of the United States' team was a statuesque young woman who had led the team in beating China earlier in the competition.
Less than two years later, in January 1986, after being substituted in a basketball game in Japan, Flo Hyman slid off the bench to sudden death. An autopsy revealed the African-American had ruptured her aorta. She was 32 years old.
Several weeks ago, a national swimmer still attending high school collapsed and died. Not long ago, it was reported that a player in the Manning Cup competition died suddenly. At a junior high school in Kingston 8, a youngster suffered an untimely death while training.
Unexpected finality
The common thread running through these sudden deaths was the unexpected finality. There was no warning, or none was recognised.
What was missing? It is hard to know after the fact. What is known? The most common cause of sudden death in young athletes is hypertrophic cardiomyopathy, an abnormal thickening of heart muscle that is usually caused by a defect in one of the proteins responsible for the contraction of the heart.
Family history is important. If a family member has died suddenly, especially under the age of 40, there is reason to check the survivors if the necropsy points to a hypertrophic cardiomyopathy.
Recognition
The next most common is Marfan syndrome. In these athletes, a building block is missing. Each time the heart beats, the aorta stretches. As many as 50 per cent of these young people are dead by age 32. The aorta has become too weak to withstand the stretch, some 110,000 times a day in the average beating heart. One may rest if tired, but the heart has to carry on. It was this that the silver medallist Flo Hyman had, unaware she was vulnerable.
It is the tall, near-sighted athlete who has the most common physical appearance: slim, gangly, with long arms, legs and fingers. Though I have patients like the silver medallist who are well-built, carrying the diagnosis, all are vulnerable to a brief flurry.
Of course, there are those afflicted whose illnesses are self-inflicted; due to drug use. Cocaine may cause chest pain. It may lead to a heart attack. This pain may also herald the same illness from which Flo Hyman died: a rupture of the aorta; in her case inherited, in others, self-inflicted.
An echocardiogram can, in five minutes, indicate whether one has either condition. To be sure, there are other conditions that may precipitate death. Prevailing culture is one. Unusual heart rhythms are another. Both can be managed. They only require willpower.
Premature death
Other circumstances leading to sudden death do occur, such as sinus of Valsalva aneurysms or coronary artery anomalies. The American, Pete Maravich, an NBA legend, had an unusual link-up of the arteries supplying his heart with blood. This malformation was diagnosed as the cause of his premature death.
How does one get an echocardiogram, a test that requires no needles? Ask your school to refer you to a hospital or other medical faci-lity that administers the test.
A sunset, purple in majesty or clothed in amber streaks, may take your breath away. Heavy clouds, pregnant with a simmering illness may also take your breath away, albeit prematurely. Today, you have the opportunity to choose.
William A.A. Foster is a consultant cardiologist. Email feedback to columns@gleanerjm.com or waafoster@hotmail.com.
Symptoms of hypertrophic cardiomyopathy
Fainting.
Blackouts.
Racing of the heart or an irregular heart rhythm.
Shortness of breath.
'The aorta has become too weak to withstand the stretch, some 110,000 times a day in the average beating heart'.