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The Rockaway Times
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Athletes andHCM
Sudden death in young com-
petitive athletes is a highly visi-
ble medical and societal issue.
In order to further investigate
and probe the causes of death in
these young healthy-appearing
athletes the Minneapolis Heart
Institute Foundation created the
US National Registry of Sudden
Death in Athletes (1980 to 2011).
The results of their investigation
were published last month in
The American Journal of Medi-
cine. Data sources used to create
the Registry included LexisNexis,
NCAAMemorial Resolutions List,
news media accounts, internet
searches, US Consumer Prod-
uct Safety Commission, records
from the National Center for Cat-
astrophic Sports Injury Research
(UNC, Chapel Hill, NC), and re-
ports from physicians, attorneys,
coroners, schools, and various
The Registry identified 2,406
athlete deaths during the 32 years
of the study. Of that number, 214
were found to have no reported
cause of death, 886 were judged
to have died of a non-cardiac
cause, and 464 had instantane-
ous collapse and death during
or just after exercise which was
judged to have been probable
but unproven cardiovascular
death. The remaining 842 cases
with confirmed cardiovascular
diagnoses made up the primary
study group.
Of the 842 confirmed cardio-
vascular deaths, 36 percent were
found to have hypertrophic car-
diomyopathy (HCM). The re-
maining 64 percent died of oth-
er varied cardiovascular causes,
none of whicheven came close to
the number with HCM. HCM is
an inherited, or genetic, disease
in which a part of the heart wall
becomes abnormally thickened,
eventually causing a restriction
to blood flow through the heart.
During exercise heart rate, res-
piratory rate, and blood pressure
all rise tomeet the increased oxy-
gen demands of themuscles.The
increased heart rate and pressure
within the heart in someone with
HCM can trigger a fatal arrhyth-
mia (abnormal electrical activity)
which causes instantaneous col-
lapse and death. HCMcan usual-
ly be diagnosed during amedical
exam as it often causes a heart
murmur and abnormal electro-
cardiogram (ECG). HCM was
found to be common inmale ath-
letes but uncommon in females.
Of the 842 athletes, 54 percent
were white, 42 percent were Afri-
other minorities. Males account-
ed for 89 percent and females
11 percent. However HCM was
more common in African-Amer-
icans (42 percent) as opposed to
whites (31 percent). Cardiovas-
cular sudden death in male bas-
ketball players was 3 times more
common in African-Americans
and other minorities than whites.
Similar numbers were found in
female basketball players.
It is clear then that young peo-
ple, especially minorities, look-
ing to play competitive sports,
particularly basketball, baseball,
track, soccer, and football, should
undergo a complete medical
evaluation before beginning any
strenuous exercise. That evalua-
tion should include an ECG and
any heart murmur, however faint,
should be evaluated with cardiac
testing including echocardiogra-
phy. If HCM is diagnosed, it can
be treated with medication and
sometimes surgery. A diagnosis
of HCM will preclude competi-
tive sports activities but will allow
a young person to live a long life
andnot die suddenly at too young
of an age.
This column is published bi-
weekly. Questions and comments
may be sent to editor@rockaway-
By Peter Galvin, MD