December 8th, 2011 at 12:32 PM ^

some doctors do them as part of the physical but many do not. Suprising that it wouldn't occur as part of a physical at a big D-1 program like this. I would think that they would go as far as to conduct MRI's and pysical stress tests along with everything else but apparently that isn't the case. A damn shame.


December 8th, 2011 at 12:37 PM ^

sudden death in young athletes typically is seen with hypertrophic cardiomyopathy.

VERY hard to diagnose.  ECG MAY show something, but it's hard to differentiate the increased ventricular size seen in well conditioned athletes from cardiomyopathy.

MRI, again, would be very difficult to identify normal increased size in athletes with cardiomyopathy unless you have serial MRIs as comparison.

Definitive DX is a biopsy...but not many people will volunteer for a heart biopsy without symptoms.


December 8th, 2011 at 3:35 PM ^

Not radiology, but would echo be able to differentiate pathologic hypertrophic cardiomyopathy versus ventricular remodeling seen in athletes? I've used ultrasound for injections & have seen demos for the shoulder...would not say things are crystal clear by any stretch but then again, I know it's VERY operator dependent. 

Not being a dick but curious.  FWIW I had a friend in high school pass away during track from HCM.


December 8th, 2011 at 3:42 PM ^

it would be able to differentiate different patterns of hypertrophy including which ones are more prone to cause problems (such as obscuring outflow tracts etc).  at the very least it'd be able to tell you better who was at risk and needs a biopsy/further work up, certainly more so than the current treatment guidelines


December 8th, 2011 at 12:53 PM ^

football and currently run track at a Division III college, and even though it's a smaller school there aren't any sorts of stress tests that the doctors run to check heart function.

It would be fairly costly for them, and there are quite a few athletes that they have to check out. It's more of just a check of the major ligaments in the knees, asking you if you've had any pain in other places, and checking for a hernia.

Most athletes seem to be in good health and would probably never think about having any testing done on their heart function. It's really too bad when something like this happens. 

EZ Bud

December 8th, 2011 at 1:55 PM ^

The only way to diagnose this is through an ultrasound of the heart where they will capture images of the heart in various stages of pumping, or a heart biopsy. Neither is cheap. A few years back I had an EKG, stress test, and heart ultrasound done and it rolled up to around $3,500 (thankfully I was fine, have great health insurance and barely paid a dime). I can't see universities dishing out that kind of money for a non-revenue sport, but perhaps for football/basketball.


December 8th, 2011 at 1:57 PM ^

I am not a physician so please ignore the ignorance of my question.  I do a lot of layman-level research on physical fitness and diet and it just seems to me that as players get bigger (ex: Molk is now considered small at 6' 0" and 290), and eat what's necessary to get that way, they're exposing themselves to a greater level of risk of these types of events.  This obviously does not consider any potential use of drugs (steroids, etc) to get that way.  The question to those that know, is this a valid point or am I off base?


December 8th, 2011 at 3:15 PM ^

No. At that age you can be set to run for the Biggest Loser and you still wouldn't be at a high risk for having a heart attack unless there's something wrong with your heart. There might be a 1 in a million case where this happens, but generally that's the case. 


December 8th, 2011 at 3:20 PM ^

The risk of these events lays not in the size of the heart but in the way that the heart grows.  In a normal athlete the heart is of course going to grow secondary to exercise but it will grow symmetrically and in a healthy way.  A lot of the incidents we hear about are people who are genetically predestined to have their hearts grow in a asymetric or unhealthy way.  The reason that you see this happening a lot in athletes isn't because the incidence of hypertrophic cardiomyopathy is higher in atheletes but rather that the exercise induces cardiac events.  The same disorder in this young man may have not been fatal had he not been playing foorball simply because he wouldn't have strained his heart as much.  So it's true athletes are at a greater risk of cardiac events but more so because of the strain on the heart during the exercise, not becuase of the heart condition itself (I realize this ia a nit picking difference but it's one I think is important)

/if that didn't make any sense feel free to ask for clarification (or to disagree etc)


December 8th, 2011 at 3:38 PM ^

That makes sense.  That said, hypothetically if you had two people of equal stature, heart size and basic heart health, both played football, and one of them packed on an additional 50 lbs (fat and/or muscle), would his heart be more susceptible to cardiac incidence because it's supporting more mass?  Thanks for your insights.


December 8th, 2011 at 3:50 PM ^

theoretically yes but at such a small increased incidence as to not really matter.  Being overweight taxes your heart without question but the difference between say denard and molk is negligable considering both are well conditioned athletes.  the other thing you have to remember is that the person who's heavier, is used to that weight being on.  he trained with that weight, worked out with the weight and plays with the weight so his heart is used to it.  if denard decided to carry around 50lbs his heart would work more for sure, but it wouldn't be enough to send it into failure because it's used to the increased effort.

when you get into non well conditioned athletes the picture is drastically different and an extra 50lbs of fat does matter. in this case (the young man from Oregon stat) him being 50 lbs lighter most likely wouldn't have mattered.

/stipulation- i obviously don't have his medical record for risk factors etc

//insert standard pitch for people to lose weight, stop smoking, exercise, eat right


December 8th, 2011 at 4:08 PM ^

Thanks again for the feedback.  At first blush, I would have thought there would have been a greater difference, but what you stated about the comparison of two "well conditioned athletes" certainly is different than a similar comparison of every-day people.  That clears it up, thanks!


December 8th, 2011 at 3:03 PM ^

As a former varsity BIG athlete I can tell you that, yes, there are heart tests. My first physical freshman year was a 3-4 hour affair. I mentioned a history of heart attacks in my family and was immediately taken upstairs for an EKG and some other heart test. I also had to take an asthma/breathing test and was retested annually for breathing and lipid profile.
<br>However, after freshman year the physicals were about 30-45 min and covered a lot less. If I ever wanted to see a doctor about anything from STI's to injuries, to cholesterol tests, all I had to do was ask. That is the key though, you have to ask/raise the issue. Its on you to be complete and proactive about family history, medications, and concerns. As long as you raise the issue, its the best healthcare I will ever have.
<br>Aside, how many people mention the annual cost of healthcare provided in the "should athletes be paid" discussion. I know I got my money's worth.