Getting to the heart of the matter
View(s):After the sudden deaths of four young athletes Dr. Asoka Thenabadu advises worried students and parents
Four deaths have occurred in the past two months of young adults during strenuous events at school sports meets. This has caused a great deal of concern among athletes, coaches and parents.
There is a rare condition in Paediatrics called Hypertrophic Obstructive Cardiomyopathy which causes sudden death when the heart is excessively stressed as in doing marathons. The exact incidence is not known but varies according to race and locality. The condition is caused by an abnormal gene. Most of these patients have been asymptomatic and leading normal lives but a few may have mild breathlessness on exertion. In this condition, the heart muscle is enlarged and can cause obstruction to the flow of blood, especially during severe exercise, leading to sudden death.
During my early days as a young doctor, I had a colleague who had a heart murmur. Very obligingly, he allowed most of the doctors in the hospital mess to listen to his murmur. However no investigations had been done as this was in the late 60’s when sophisticated cardiological investigations were not available. Suddenly one night, there was loud banging on my door and I was told that ”………..has died”. No post mortem was done to spare the family the trauma and a clinical diagnosis of Hypertrophic Obstructive Cardiomyopathy was made and a death certificate was issued.
As this is a relatively rare condition, mass screening is inappropriate and is not recommended by the American Cardiological Association, although this is the commonest cause of death among American athletes. However, if athletes and parents are worried they must seek a cardiological opinion when certain tests like ECG’s, Echo cardiograms and Cardiac Magnetic Resonance Imaging may be done. Specific genetic tests are also available now. Medication may be prescribed if the condition is diagnosed and the patient counselled appropriately.
(The writer is a Retired Consultant Paediatrician)
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