On November 21 the Detroit Red
Wings' star defenceman Jiri Fischer's heart stopped and
he collapsed in convulsions on the bench. Luckily, team
physician Dr Tony Colucci and five medics were able to
restart his heart with a defibrillator. Mr Fischer is
now back on his feet, but the cause of his heart failure
has not been disclosed, and it's unclear whether he'll
ever return to the ice.
Just weeks earlier, living hockey
legend Mario Lemieux was removed from the Pittsburgh
Penguin lineup when doctors discovered he had an atrial
fibrillation problem, leading many to wonder why so
many elite athletes suffer from heart trouble.
WHAT'S
ARVD?
In September 2002, Mr Fischer was found to have an abnormally
thick heart but cleared to play anyway. Now there's
speculation Mr Fischer actually suffers from arrythmogenic
right ventricular dysplasia (ARVD), a rare form of cardiomyopathy
that disproportionately afflicts young, otherwise healthy
athletes. ARVD presents with a range of symptoms that
may appear up to 15 years before diagnosis, including
palpitations, dizziness and fainting. Excess fatty tissue
in the right ventricle leads to increased risk of ventricular
arrhythmias and possible sudden cardiac death. Researchers
from Johns Hopkins recently published a comprehensive
description of the condition in the online edition of
Circulation.
"Physicians should be on the lookout
for early signs and symptoms [of ARVD] because it's
an important cause of sudden cardiac death in healthy
young individuals," study author Dr Hugh Calkins told
the press. "If a young person faints, especially in
association with exercise, their physician should evaluate
them carefully for cardiac diseases," added co-author
Dr Darshan Dalal. Up to 10 tests are required to confirm
an ARVD diagnosis.
DON'T
BLAME SPORT
Dr Ian Cohen, the Toronto Argonauts' team physician
and an instructor with U of T's Faculty of Physical
Education and Health, has seen his share of athletes
with heart problems. "Generally the problems weren't
attributable to the fact that they were athletes," specified
Dr Cohen. He would only worry about sports putting a
young athlete's ticker at risk if there's a strong family
history of cardiomyopathy. The Johns Hopkins group also
concluded that sudden death in competitive athletes
is most often due to underlying structural heart disease.
There's nothing new about elite
athletes' hearts failing. Legend has it that way back
in 490BC, the Greek hero Pheidippides dropped dead upon
finishing the 42km run from Marathon to Athens because
of "joy in his blood bursting his heart."
Today, performance enhancing drugs
surely play a role in at least some of the cases of
heart problems in young athletes. "Research evidence
shows that up to 50% of NCAA hockey players admit to
using ephedrine," said Dr Cohen. "Cardiac arrhythmia
and sudden death are well documented in athletes who
have taken ephedrine-ephedra for performance enhancement."
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