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Vital Signs

Winter 2007

Detecting Heart Conditions in the Student Athlete

Tragic stories of young athletes dying suddenly while training or competing can leave parents wondering about their own child’s risks. The most common cause of death in young athletes is hypertrophic cardiomyopathy (HCM)— an excessive thickening of the wall of the heart’s left ventricle, which, when stressed by exercise, can cause the heart to stop.

 “The symptoms are usually silent and therefore generally not picked up on a routine examination,” says UCLA interventional cardiologist Michael S. Lee, M.D. However, cautionary signs may point to the need for further medical evaluation, explains John DiFiori, M.D., UCLA sports medicine specialist.

A comprehensive pre-participation evaluation is recommended for every student athlete and should include a family history of premature cardiacrelated deaths or known history of HCM, and questions about such symptoms as fainting or near-fainting associated with exercise, exertional chest pain, tightness or discomfort, excessive exertional shortness of breath or fatigue, and a history of a heart murmur.

If concerns arise during the evaluation, Drs. Lee and DiFiori say, the student athlete should undergo a screening electrocardiogram and echocardiogram, which can confirm or rule out a diagnosis of HCM and many other congenital or acquired heart conditions. A child diagnosed with HCM should be restricted from participating in most competitive sports, but may participate in some low-intensity sports, such as golf. “We want these children to live long, happy lives, and the best way to ensure that is to manage their disease while allowing them to continue as engaged members of their schools and community,” Dr. DiFiori says.

Treatment of HCM may include beta blockers, surgery to reduce the thickening of the heart wall, or implantation of an internal cardiac defibrillator (ICD), which has clearly been shown to prevent sudden death in those with HCM.

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