Sudden Death in Athletes May Sometimes Be Prevented
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
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
"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
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
Because most conditions that cause sudden death are hereditary, Smith says
he relies heavily on an athlete's family history and historical profile.
"You'll find more things with the history than you will with the physical
exam," he tells WebMD.
Even screening isn't an ideal safety net, Smith says. For example, he says,
Italy has a very thorough screening program for its young competitive
"They're a small country," he says. "They've got some
governmental support and some regulation to do those kinds of things. I think
that's what dictates why they have such an extensive screening program. Even
so, with that said, they still have cases of sudden deaths in athletes. ? The
United States is so much larger, and a little less than a fourth of those cases
came out of Italy.
"It goes to show you that even the best screening programs are not going
to be absolute in prevention."