By Pat Lovgren
One would hope hypertrophic cardiomyopathy (HCM) – the disease responsible for the greatest number of deaths among young athletes – would be something most athletes and coaches would know about especially because of the long list of athletes who have recently become victims of the disease.
The long list is headed by New York Rangers top prospect, Alexei Cherepanov, who died from the disease after collapsing during a hockey game in Russia. However, when it comes to knowledge of the condition, medical experts say athletes are still mostly in the dark – a situation that Lisa Salberg, founder and CEO of the Hypertrophic Cardiomyopathy Association, wants to change by focusing on education.
“Given the constraints, educating and informing athletes are the best tools we have,” says Salberg. “What people should be looking at is if anyone in your family has died suddenly. You have to ask, ‘what’s your family history?’ Many people don’t really know. It’s important they get checked out so hopefully we can rule it out.”
According to the HCMA, hypertrophic cardiomyopathy is a type of sudden cardiac death from which 5,000 to 7,000 young athletes die from each year. The HCMA says it affects approximately one in 500 people in North America. The disease is characterized by a thickening of the heart muscle and is genetically passed down through families. Participation in sports by athletes who have HCM puts them in serious harm because of the stress and strain physical activity demands.
In recent years, primarily due to the numerous deaths among athletes, professional sports teams have required their athletes to undergo ECG (also known as EKG) tests; procedures not as thorough as electrocardiograms, but still effective in detecting heart disease in the opinion of leading cardiologists.
Recently, FIFA, the international body that governs soccer said that, “preventative screening (for heart diseases like HCM) should consist three specific aspects: a meticulous (family and personal) history; a thorough examination and an electrocardiogram.
According to a recent study by the Minneapolis Heart Institute (MHI), all 32 National Football League teams administer EKGs as part of physical exams. Ninety-three per cent of major league baseball and National Basketball Association teams do EKG testing, as do 80 per cent of NHL clubs.
The study also found that 27 cent of NBA teams administer the more thorough, recommended echocardiogram testing, followed by MLB (13 per cent), NHL (seven per cent) and NFL (six per cent).
In amateur sports its another stor`y, leading Salberg and Diana Drury, the head of the athletic department at St. Lawrence College, to call for education and awareness strategies.
Drury says her school tells its coaches to be alert to the warning signs.
“The athletes need to be educated,” Drury says. “We sit down with the coaches before every season and talk about the important issues so they know what to look for and what to tell their players. Coaches have to watch their athletes and make sure they are performing at their normal levels.”
Salberg says its important athletes stay hydrated and consume as many electrolytes as possible during competition.
“Coaches have to watch their athletes and make sure they’re competing at their normal levels during practices and games,” she says. “Any unusual drop-off in performance should be handled with care and not just taken by coaches as if their athletes are underperforming or slacking off.”
Jolande Amoraal, a former college badminton and volleyball players, experienced some heart related problems herself. She says athletes should take the initiative, do their own research and get checked out if they have any reservations about their health.
“It’s important to talk to your doctor and go for a physical and not rely solely on college therapists,” says Amoraal who underwent ECG and echocardiogram tests to be certain her symptoms were not serious.
Although the Canadian Centre for Ethics in Sport (CCES) is responsible for administering drug testing for college athletics, each college must create and administer its own medical questionnaires.
Drury says she would like to see the OCAA implement a set of health questions that all schools would be required to follow.
“I’d like to see something done with the OCAA,” Drury says. “I think there needs to be a uniform testing system where all the schools get in line and come up with a common set of guidelines.”
As Humber athletic therapist Lydia Henry says, it’s ultimately up to the athletes to be forthcoming with their medical history.
“Even though we require them to go through the medical sheet, you can’t stop people from lying to you; there’s only so much you can do,” she says.
Drury says one of the reasons athletes are reluctant to come forward is because there is a fear of what others may think.
“There are very few that come forward,” Drury says. “It’s tough to admit if there is a problem because they don’t want the stigma attached to them.”
Similarly, Salberg says athletes sometimes don’t want to face the potential consequences a serious condition like HCM presents.
“I have found there is definitely a fear that athletes have that they may no longer be able to compete in the sport they love,” she says.
Amoraal says athletes may be reluctant to tell someone about an injury because in the spirit of competition – where athletes are encouraged to play through injuries and not give in to pain – admitting to an injury that may not be apparent is rarely done.
“I think it would be easier if athletes saw other people coming forward,” she says. “Further research and studies need to be done so athletes know what to look for.”
Drury says it’s a 50/50 proposition in which athletes, their coaches and administrators should be working together to understand the dangers associated with diseases such as HCM.
However, she says ultimately the decision to come forward is up to those competing between the lines.
“You can only do so much,” Drury says. “In the end it’s up to the athletes.”
Sidebar
David Carle’s says things could have been a lot worse. Carle was projected to be a second or third round pick in the 2007 NHL draft coming out of the University of Denver before he received news that would forever change his life. He was diagnosed with hypertrophic cardiomyopathy the day before the draft and was subsequently forced to retire. His hockey career abruptly over, Carle could have easily let the devastating news consume him, but instead turned it into a positive. He stayed on as an assistant coach at UD and is writing a blog for espn.com that he uses to talk about his team and also educate people about HCM. The story doesn’t end there however; the Tampa Bay Lightning selected Carle with their seventh round pick – fully realizing he would never play a game for them ¬– allowing him to fulfill his dream of being drafted into the NHL.
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