A 23-year-old footballer dies on the field. A 17-year-old athlete keels over during a basketball game and never gets up. A 31-year-old hockey player collapses on his way to the locker room, minutes after a game. Sudden death in young people is rare, but the stories are heart-breaking head-scratchers that beg the question: What causes the sudden death of seemingly healthy young athletes?
Heart problems are often to blame.
Dr. Robert Myers, a cardiologist at Sunnybrook Health Sciences Centre, says sudden death in young people is rare, but there are several causes that may contribute: “an arrhythmia (irregular heartbeat) disorder; a viral illness that weakens the heart; Marphan syndrome – a connective tissue disorder that can cause the aorta to rupture; to name a few. But the most common cause is hypertrophic cardiomyopathy.”
Hypertrophic cardiomyopathy is a genetic condition where the heart muscle becomes thickened and enlarged. Myers says it is responsible for more than one-third of all sudden deaths in young people.
“A thickened heart muscle can block the flow of blood and, in rare cases, can cause a fatal arrhythmia during vigorous physical activity,” says Myers, who is also the cardiologist for all Toronto sports teams, including the Raptors, Maple Leafs, Marlies, Toronto FC, and Argonauts.
One in 500 people has hypertrophic cardiomyopathy, the majority of which go undiagnosed. Symptoms of the condition can include sudden fatigue, rapid heartbeat, dizziness, chest pain, and fainting. Although symptoms can be managed, there is no cure.
“Unexpected breathlessness, rapid heartbeat, dizziness, losing consciousness – these symptoms are red flags that need to be investigated,” says Myers. “And exercise should be restricted.”
Mandated athlete health screening varies around the world, but in Ontario, official sports league athletes are screened for the condition through family history, physicals, electrocardiograms, and sometimes ultrasounds and stress tests, explains Myers. If any abnormalities of the heart are found, the athlete is benched until their health is cleared for play. If, however, they are diagnosed with hypertrophic cardiomyopathy, they will need to manage the illness with restricted activity.
“Athletes who have this condition would not be allowed to participate in their sport,” says Myers. “Because of that, people may not come forward with their symptoms.”
Myers says anybody who wants to partake in vigorous sporting activities should look out for the symptoms, speak up if symptoms appear, and talk to their doctor about being screened.