Sunday, June 01, 2008
News

Sports’ real heartbreaker

 

By Mark Woolsey

Members of the national association of Black Coaches and Administrators (BCA) convening in Atlanta last week heard sobering and shocking news: In disproportionate numbers, young black athletes are dying suddenly from heart problems. And they heard a clarion call to do something about it by partnering with “Close the Gap,” a program started by medical-device maker Boston Scientific.

“Close the Gap” targets health care inequalities particularly among blacks, Hispanics and women. The approach involves awareness of the extent of the problem, coupled with exams and testing.
   
Statistics collected by the Centers for Disease Control show that young victims of sudden cardiac death, an electrical problem with the heart that differs from the blockage-related traditional heart attack, die about once every three days. Their average age is 17.5. Ninety percent are male and more than 50 percent are black.

What’s behind the racial disparity?
   
“I don’t know if we have the answer,” says Dr. Winston Gandy, an Atlanta cardiologist and medical director for Athletes Heartbeat, a group that tests and evaluates athletes for heart problems at the University of Georgia and for the Atlanta Falcons, among other programs. “There are a good many studies ongoing.”

Speculation has focused on what some say is a predisposition toward heart disease and hypertension among blacks, and poorer-quality health care afforded to minority groups. Genetics are strongly suspected.

“Not enough research has been done,” Gandy told The Sunday Paper in an April interview. “But it’s out there, it’s real.”
 
The issue gets hard and close to home for the black coaches’ group.
    
“One of our board members lost two close friends to sudden cardiac death,” says Troy Arthur, general manager for the Indianapolis-based organization. “One of the two was an African-American student athlete …We want BCA members to go back to their communities across the country and find ways to partner with medical professionals and community groups where they live to spread the word.”

Hypertrophic cardiomyopathy, an abnormal thickening of the heart muscle, tends to run in families. High levels of physical activity can produce ventricular fibrillation, or an electrical short circuit of the heart. It tends to crop up most often, he says, during the intense workout afforded by football or basketball.
   
But other sudden heart death causes also loom large, including Marfan Syndrome, a hereditary disorder of connective tissue, or simple coronary artery abnormalities.   

“If you’re the only African-American in a room in a group of Caucasians, the reactions are shaped by environment, and this is normal,” says Gandy. “We’re trying to get people educated enough that no matter what environment they are in, the last thing they do is shut their mouths and nod.”  
           
Athletes Heartbeat uses electrocardiograms to detect not only HCM and other potential killers, but non-life-threatening heart issues that can hinder performance or result in disqualification of an athlete if not treated. Gandy says some colleges have done such extensive testing for more than a decade, but other programs don’t, often citing cost. Gandy’s group has been able to cut the cost of screening by having medical professionals volunteer their time.
     
Others maintain that the electro-and-echo screening is not necessary in all cases. Ken Mautner of the Emory Sports Medicine Center says that in addition to cost concerns, the number of false positives argues against hooking up the heart-monitoring equipment for everyone.
      
“With 200,000 athletes, you might pick up one or two thousand people who could be at risk, and out of that you might prevent one or two deaths. So you have a few thousand people you are subjecting to the testing expense, the worry and the possible withholding from competition,” Mautner says. And, he says the EKGS are not fool-proof in any event.

“In the U.S. right now the most cost-effective and complete way to screen for sudden cardiac death or a heart problem is with an adequate patient history and a physical exam done every year or other year,” says Mautner. “And I would say the history is most important—asking questions about chest, pains, dizziness, etc. Also listening to the heart for murmurs and unusual sounds, and if things crop up, you refer them to a cardiologist.” SP