Hypotrophic Cardiomyopathy

Hypertropic Cardiomyopathy

In 409 B.C. Pheidippides, a Greek soldier and a conditioned runner ran from Marathon to Athens, a distance of 26 miles, to announce military victory over Persia. After delivering his message he collapsed and died. Pheidippides is the earliest athlete documented to die from sudden cardiac death. Today heart diseases such as, hypertrophic cardiomyopathy , idiopathic left ventricular hypertrophy and congenital coronary artery anomalies, are the most common diseases that lead to sudden death in young athletes. Athletes, such as, professional basketball player for the Boston Celtics Reggie Lewis in 1993, collegiate basketball player from Loyola Marymount, Hank Gathers, and Olympic gold medal skater, Sergi Grinkov, in 1995, have each been victims of these diseases. Hypertrophic cardiomyopathy, the main topic of this paper, is the most common cause of sudden cardiac death in young competitive athletes and the second most common form of heart muscle disease. It is important for athletes and non athletes alike to be informed of this disease and the effects it can have on all physically active people.

Hypertrophic cardiomyopathy is a congenital heart disease characterized by the abnormal thickening of the ventricular septum and the left ventricular wall. Enlargement of the ventricular septum can result in ventricular overflow obstruction (sub-aortic stenosis) and even cardiomyopathy. This means hypertrophic cardiomyopathy is a heart disease present from birth which can weaken the heart's pumping by the thickening of the ventricular septum and left ventricular creating a blockage where it is hard for the blood to pass through. It is believed to be a defect in the genes that control heart muscle growth (Sheridian 2006).

As you can see in the picture above, the right image of the heart is enlarged where the left ventricle is. Because hypertrophic cardiomyopathy causes the size of one of the heart chambers to shrink, the heart must work harder to pump blood. The thickening of the heart muscle may completly block the normal flow of blood out of the heart. It may also make it harder for the heart valves to work. Heart valves help control the direction of blood flow. Many people with hypertrophic myopathy have no symptoms. Sometimes the first and only symptom is sudden death. The heart chamber begins to beat so chaotically and fast that no blood is pumped, instead the heart quivers. For the few who do have symptoms, the most common are breathlessness and chest discomfort. Least common symptoms include fainting during physical activity, strong rapid heart beats, and fatigue. All of these symptoms, except fainting, regularly follow any type of rigorous physical activities; many people would ignore these symptoms. Fainting is the only symptom that team physicians, athletic trainers, or anyone training should never ignore. Fainting during physical activities is one of the warning signs of a potentially life threatening heart problem. Heart disease can cause a person to faint for many reasons. First, cardiac rhythm abnormality causes fainting with no warning symptoms. The heart's pumping ability is impaired and causes a decrease in blood flow. Second, an obstruction within the blood vessels in the chest can cause fainting. Third, heart failure can cause the heart's pumping ability to be impaired which then decreases blood flow to the brain (Wickelgren 2006). Besides heart problems, there are many other reasons as to why people faint, environmental factors (hot or crowded settings), emotional factors (stress), physical factors (standing with locked knees for too long), and illness factors (dehydration or low blood sugar). For this reason, a handbook for team physicians states that "an athlete who faints inexplicably during a game or practice should undergo a thorough evaluation before being allowed to compete again (Coach and Director Handbook)."

Primary Care and Sports Medicine Physicians are often asked to screen athletes for rare cardiac diseases that may predispose them to sudden death. Junior High Schools, High Schools, Colleges, and professional teams are all required to take a pre-preparation physical examination (PPE) to play sports. Although young kids are not required to have a PPE done, many doctors and coaches are now encouraging these kids to do so. In these physicals a brief medical history and physical examination is taken. The physical examination consists of a record of your height and weight, a blood pressure reading, vision test, a check of heart, lungs, abdomen, ears, nose, and throat, and an evaluation of posture, joints, strength, and flexibility. But, only some schools, in some states, require that a PPE include an electrocardiogram, or EKG. An EKG measures the electrical activity of a person's heart. Doctors might also use tests such as, Transesophageal echocardiogram, Chest X-Ray, 24