(Guest post by: Paul R Pagley, MD)
The issue of heart screening for athletes prior to participation in competitive sports has been in the news lately. Perhaps you have heard of Star Lotulelei the standout defensive lineman from the University of Utah who is projected to be selected in the first few picks of the upcoming NFL draft. At the recent NFL Combine, Star and the other draft hopefuls underwent heart screening tests such as an electrocardiogram (EKG) and a heart ultrasound or echocardiogram. Star was found to have mildly abnormal heart function due to a weakened heart muscle. He was sent home from the Combine to have further testing which will determine if it is safe for him to pursue a career in the NFL or if playing football would be too high risk for him. It is possible that his heart condition could prevent him from playing ever again.
Star’s case is just the latest in a string of athletes with heart conditions. Many will remember the case of Hank Gathers who was a college basketball player in the early 1990’s who suffered a cardiac arrest on the basketball court during a game and subsequently died. There have been many other athletes at all levels of sport, from high school to the professional ranks, who have had cardiac problems which put them at increased risk from intense physical exertion. Most of these athletes have a condition called hypertrophic cardiomyopathy which is an abnormal thickening, or hypertrophy, of the heart muscle. This abnormal thickening is associated with cardiac arrhythmias or abnormal heart rhythms which commonly will occur in situations of physical exertion. Some of these arrhythmias can be extremely dangerous and can lead to sudden cardiac death. Since hypertrophic cardiomyopathy can occur in up to 1 in 500 young adults, and since it is the leading cause of sudden death among athletes, there has been a push to identify young athletes with hypertrophic cardiomyopathy and other heart problems.
St. David’s HealthCare, the Heart Hospital of Austin and the physicians of Austin Heart have partnered with The University of Texas at Austin to bring state-of-the-art cardiac screening to the varsity athletes of The University of Texas. We have instituted a three-step process designed to identify hypertrophic cardiomyopathy or other heart problems before they result in more severe consequences.
- The athlete completes a questionnaire regarding family history and any symptoms he/she might have such as chest pain or shortness of breath or passing out when exerting.
- An EKG is performed to identify any heart rhythm abnormalities and look for evidence of hypertrophic cardiomyopathy.
- A brief screening echocardiogram is performed. An echocardiogram is a painless ultrasound examination of the heart that allows the cardiologist to identify any heart muscle or heart valve problems. The echo is accepted as the best way to make a diagnosis of hypertrophic cardiomyopathy.
If normal, this screening panel is powerful evidence that participation in competitive sports should be safe for the athlete. If abnormal, it allows the athlete to undergo further testing to assess the safety of strenuous physical exertion similar to the situation of Star Lotulelei. St. David’s HealthCare and the physicians of Austin Heart are proud to bring this service to The University of Texas at Austin and its athletes.