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The Importance Of Physicals For Young Athletes

Injured football player.Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely sedentary life. Every story of a sudden death in a young person is a tragedy, and usually accompanied by commentary pondering the role and utility of pre-activity screening. Could the death have been prevented? What was the physiological condition of the deceased? Could the collapse, often attributed to a heart problem, have been predicted? Was there an examination or evaluation that might have indicated that the deceased was at greater risk, or should have been held out of the activity? These are all important questions, with no simple answers.

Sudden collapse and cardiac arrest in a young person seems wrong. It shouldn’t happen. It is a parent’s worst nightmare. Similar horrors occur on the freeway when a teenage driver is killed, or at the beach when a surfer is tossed in a monster wave and drowned. We know a great deal about injury prevention; much of our teaching and experience points to errors in judgment. But the situation is different when the seemingly healthy slumps to the ground without a pulse. That person has been taken by surprise in a cruel act of fate.

Sometimes we learn that the victim had Read more »

This post, The Importance Of Physicals For Young Athletes, was originally published on Healthine.com by Paul Auerbach, M.D..

The Athletic Heart: How It Functions

It may seem a little formal to say this, but I would like to start by stating my goals for today’s post:

  • Introduce the concept of the athletic heart;
  • Touch upon the notion of sudden death of the athlete;
  • Explain what an ECG really is, and how it may help diagnose heart disease;
  • Review a recent study about the common ECG variant seen in athletes…Early repolarization.

Intro: The adaptations of the human heart never cease to amaze me. Physical training transforms our hearts into high performance engines. Repeated sessions of interval training, combined with longer aerobic efforts, and sprinkled with adequate rest maximize our ability to keep pressure on the pedals, or run the sixth mile of the 10k at the same pace as the first, or for you swimmers, to keep getting back to the wall on the 1:15 mark.

Fitness also brings measurable changes in things we can observe. Read more »

*This blog post was originally published at Dr John M*

Heart Rate: What’s Normal?

The “normal” number of heartbeats per minute is very much a frequently asked question. People, especially medical people, like well-defined lows and highs. Parameters which can be assigned an ‘L’ or ‘H’ makes life easier.

2009 National Championship Masters (45-49) Road Race

As a modern-day competitive cyclist, I am immersed in a sea of information. In our quest for weekend glory, minutia like speed, wattage outputs, RPMs, torque, elevation gain and of course, heart rates (highs, lows, and averages) get recorded, downloaded, and then studied intensively.

As a heart rhythm specialist, it is a frequent occurrence to see patients referred for low or high heart rates. More often than not, heart doctors are called upon to adjudicate patients who fall outside the “normal” values.

The old school teaching holds that the normal resting heart rate is greater than 55 and less than 100 beats per minute (bpm). Maximal heart rates are estimated by the Read more »

*This blog post was originally published at Dr John M*

Universal Cardiac Screening For All Young Athletes?

It’s heart wrenching when young athletes die of sudden cardiac death (SCD). Last week the death of Wes Leonard, a Michigan high school star athlete, was especially poignant since he collapsed right after making the game-winning shot. This sort of tragedy occurs about one hundred times each year in America. That’s a lot of sadness. The obvious question is: Could these deaths be prevented? Let’s start with what actually happens.

Most cases of sudden death in young people occur as a result of either hypertrophic cardiomyopathy (HCM), an abnormal thickening of heart muscle, or long QT syndrome (LQTS), a mostly inherited disease of the heart’s electrical system. Both HCM and LQTS predispose the heart to ventricular fibrillation — electrical chaos of the pumping chamber of the heart. The adrenaline surges of athletic competition increase the odds of this chaos. Unfortunately, like heart disease often does, both these ailments can strike without warning.

Sudden death is sad enough by itself, but what makes it even worse is that both these ailments are mostly detectable with two simple painless tests: The ECG and echocardiogram (heart ultrasound). Let’s get these kids ECGs and echos then. “Git ‘er dun,” you might say.

On the surface the solution seems simple: Implement universal cardiac screening of all young athletes. And you wouldn’t be alone in thinking this way. You could even boast the support of Dr. Manny Alvarez of Fox News and the entire country of Italy, where all athletes get ECGs and echos before competing. But America isn’t Italy, and things aren’t as simple as Fox News likes to suggest. Read more »

*This blog post was originally published at Dr John M*

Sudden Death In Young Athletes And Routine Cardiac Screening

It’s the dog days of what seems to have been an unusually hot summer (though DrRich does not know whether it has been sufficiently warm to affect the global cooling trend we’ve been in for the past decade), and as is all too common at this time of year, we are seeing extraordinarily heartbreaking stories (like this one) about healthy, robust young athletes dying suddenly on the practice fields.

Most of these tragic sudden deaths are due to a heart condition called hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy often does not produce any symptoms prior to causing sudden death. But it can be easily diagnosed, before exercise-induced sudden death occurs, by screening young athletes with electocardiograms (ECGs) and echocardiography.

A couple of summers ago, the New York Times wrote about such an athletic screening program at the University of Tennessee. Based on the U of T’s results, “cardiologists and other heart experts say that the screenings could help save the lives of the 125 American athletes younger than 35 who die each year of sudden cardiac death.” Read more »

*This blog post was originally published at The Covert Rationing Blog*

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