Sudden Death in Athletes May Sometimes Be Prevented
Mahesh Amin, MD, a Florida cardiologist, explains that a lot of people, relatively speaking, have anomalous coronary arteries. But when the coronary grows between the pulmonary artery and the aorta, which it tends to do, that may cause a problem -- especially for athletes. "When the young athlete is exercising, both of [the arteries] dilate and squeeze the coronary artery going between them, leading to a heart attack," Amin says.
Basso says that an ultrasound imaging procedure, called echocardiogram, may be used to diagnose the condition, or to rule it out. If an athlete has coronary artery anomaly, he or she should not play competitive sports.
"It does not mean that you always have to perform echocardiogram, but if you are dealing with an athlete with some signs like angina or syncope during effort, we think that you should also perform an echocardiograph examination," he tells WebMD. "The problem is the cost-and-benefit ratio, of course, but we think it's the best way to prevent sudden death with these athletes."
Bryan Smith, MD, tells WebMD that a loss of consciousness would definitely get his attention. "Chest pain by itself, that's a non-specific finding, particularly in the young athlete; it's kind of hard to know how meaningful that is. Now syncope's a different story. ? If you have syncope with activity, that's a red flag for clinicians and that needs to be taken pretty seriously, and needs to be well evaluated." Smith is a member of the sports medicine staff at the University of North Carolina (UNC) at Chapel Hill.
Smith says that following up on these problems with appropriate tests "is probably good advice. ? The more physicians are educated in looking for some of these things and asking the right question [of] the athlete, they may find that their ability to diagnose these conditions ahead of time is enhanced.
"If you look at it from a cost analysis standpoint, it probably is a very costly process to engage in, but yet, it's hard to put a value on human life."
Amin, who also is director of research for Morton Plant Mease Health Care, says the costs of pre-participation screening, at least in his community of Clearwater, Fla., are "tremendous." In that area, he says, even a basic EKG costs $900. "It's actually a question for the community to answer," he says. "How much are they willing to pay to save one life or two?"