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Physicians Update

Winter 2008: Heart

Sudden Death in the Young Athlete

A simple echocardiogram can be used to diagnose hypertrophic cardiomyopathy—a relatively common genetic cardiac disorder, characterized by an excessive thickening of the heart muscle, that affects about 1 in 500 people—but because it is so heterogeneous in its presentation, it is often missed in primary-care settings, according to Michael S. Lee, M.D., UCLA interventional cardiologist. “When you see high school or college athletes who die suddenly even though they underwent screening for hypertrophic cardiomyopathy before they were cleared to play, it reminds you how important it is that physicians ask the right questions,” Dr. Lee explains.

Appropriate screening should include inquiries about whether any first-degree relatives have had the condition, as well as listening for a heart murmur and checking for any history of chest pain, shortness of breath, fatigue, palpitations, light-headedness, dizziness or blackouts, Dr. Lee says. He points out that although there is no cure, treatments with beta-blockers and calcium antagonists can reduce symptoms. Patients who still have symptoms despite medication can either undergo a minimally invasive procedure or surgery to relieve symptoms; patients at risk for sudden death should be screened for possible use of an implanted defibrillator.

“Hypertrophic cardiomyopathy is a complex disease that can have catastrophic consequences,” Dr. Lee concludes. “Patients may have debilitating symptoms that severely affect their quality of life. Appropriate screening and identification of patients who are at high risk for sudden death is critical, and physicians who specialize in this disease process should be the ones providing the treatment.”

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