SUDDEN DEATH of Young Athletes Can Be Prevented.

• Author: SIEGEL, ROBERT J.
• Position: Hypertrophic cardiomyopathy - Statistical Data Included

KEVIN RICHARDS, an Evanston (Ill.) High School track runner, died in February, 2000, after finishing second in a race.

* Tim Collins, Lafayette High School, Lexington, Ky., died in November, 1999, during basketball practice.

* Steven "Scotty" Lang, a Fountain Valley (Calif.) High School football player, died in November, 1999, during practice drills.

* John Stewart, a University of Kentucky basketball recruit, died in March, 1999, during a regional championship high school basketball game in Columbus, Ind.

* Gerald Grainger, Zion-Benton Township High School, Chicago, Ill., died in September, 1997, following a long-distance run in gym class.

The list is lengthy. These high school athletes are sad proof that heart disease--the nation's number-one killer--takes youngsters as well as adults. Sudden death on the playing field is a high-visibility tragedy that claims the lives of seemingly healthy young people, athletes and nonathletes alike.

Many of these sudden deaths were caused by an asymptomatic heart condition for which there was no obvious warning. One of the so-called "silent" conditions is hypertrophic cardiomyopathy (HCM), a disorder in which the heart muscle unexplainably becomes excessively thick. This condition can be present with--or without--symptoms such as chest pain, shortness of breath, or fainting. Unfortunately for victims, the first symptom can be death itself, with the condition not diagnosed until an autopsy is performed.

A thickened heart muscle (in HCM, predominantly of the left ventricle) is more sensitive to a lack of blood supply and more irritable than a normal heart. As a consequence of this irritability, the heart is more prone to dangerous forms of heart irregularities, such as ventricular tachycardia or ventricular fibrillation, which can render heart contractions fatally ineffective, unless treated.

HCM is thought to cause one out of every three cases of sudden death among athletes, and approximately one person in 500 births is affected by HCM. The disease is hereditary in more than half the cases.

Athletes with HCM are at greater risk because the two factors that are thought to trigger a catastrophic event in a hypertrophied heart muscle that characterizes this condition are dehydration and increased adrenaline. Both are common situations during physical exertion.

The good news is that, if detected, even "silent" heart conditions such as HCM can be treated. However, physicians cannot treat what is not diagnosed, and, in the case of young athletes, the longtime standard of pre-sports physical exams may not go far enough to find defects and avert tragedy. In the majority of "regular" exams, the physician listens to the heart's sounds with a stethoscope. This...