Friday, January 23, 2009

Sudden Death in Student Athletes


On December 5, 2008, the very renowned Dr. William A. A. Foster, Professor of Medicine at the University of the West Indies wrote that “A sunset, purple in majesty or clothed in amber streaks, may take your breath away. Heavy clouds, pregnant with a simmering illness may also take your breath away, albeit prematurely. Today, you have the opportunity to choose.”

The point being made by Dr. Foster is that technology and medicine now has the wherewithal to decipher between those who are at risk of sudden death from exertion and healthy individuals who can stress their bodies to extremes without being subjected to any health consequences. There are enough sad stories of sudden death in young athletes, (the captain of the USA Volleyball team in the 1984 Olympics, Flo Hyman, a 32 year old basketball player, Pete Maravich, an NBA Legend, as well as many others) to get our attention, particularly now that it can be avoided with a through history and physical examination and some simple non-invasive tests.

Exercise, track and field, and sports in general are of great public interest in Jamaica where we have an excellent sports tradition and our athletes are world class. The perception is that our athletes are physically fit and the picture of health. This misconception has fuelled a carefree attitude to health of athletes and unfortunately diseases of athletes have received scant attention until the sudden death of Mr. Matthew Hilton (18 yrs.), swimmer of Ardenne High School and Terrence Golding (17 years) footballer from Eltham High School, brought home to all of us that sudden death of young athletes during competition is tragic but avoidable with proper screening. It is therefore our duty and responsibility to determine, with a reasonable degree of reliability, whether students who are participating in sports are free from cardiovascular abnormalities that could increase the risk of death during athletic training and competition. It is shocking when a young gifted college student who is asymptomatic, dies suddenly during competition. These deaths are not flukes.

Just like strokes are the result of uncontrolled high blood pressure, many causes of sudden death in athletes can be identified and effectively addressed. Because of this advancement in medicine, there now seems to be a spirit of collaboration between physicians, coaches, institutions of higher learning and sports organizations to use the clinical and technological advances in medicine for the screening and identification of individuals at risk. The result of these screening examinations may establish the criteria for eligibility and disqualification from competitive sports. By doing so, we are able to prevent these devastating conditions from destroying hearts too young to die. For most students, participation in sports has both physical and social benefits but for some, the consequence is death. Athletic programs at high schools and universities must use reasonable medical care in conducting their athletic programs.

Screening all competitive athletes reduces exercise-related acute cardiovascular events in a cost effective way. For less than US$300.00 per student, they can be assured that a reliable cardiovascular evaluation has been done to exclude major known causes of sudden death and that they have been cleared for participation in athletic training and competition or be advised otherwise. Doing so reduces exercise-related acute cardiovascular events/death in a cost effective way. It is undisputed that a high percentage of athletes at risk for sudden death can be identified with the proposed protocol. Many more years of life are gained by saving an adolescent with most of he conditions responsible for sudden cardiac death than would be saved by screening strategies that target older Jamaicans. The decision to spend money on preventing some finite number of potentially avoidable deaths in student athletes should be a priority for all educational institutions as well as all athletes who participate in sports.

No comments:

Post a Comment