Dr. Martin O'Riordan Works with Area Team Doctors and Athletic Trainers to Identify Athletes Who Are At Potential Risk

(WYNNEWOOD, PA; October 2007) -- A Lankenau Hospital cardiologist has started a screening program to identify athletes who might be at risk for sudden cardiac death, a tragic, but rare occurrence that evokes a highly emotional public response.

Sudden death claims the lives of amateur and high-profile athletes alike at a rate of one in 50,000 to one in 200,000 annually, according to Martin J. O'Riordan, MD , director of the Adult Congenital Heart Program at Lankenau.

 "The incidence is relatively small, but the impact is great on society because these athletes are seemingly among the most fit and well-conditioned individuals among us," said Dr. O'Riordan. "These sudden deaths make people wonder if anything could have been done to prevent them."

Unlike countries such as Italy and Germany, there is no organized screening of America's youth athletes to determine if any carry a congenital birth defect or other risk factor that could predispose them to a fatal arrhythmia.

According to Dr. O'Riordan, screening of athletes in our country is recommended, but is not mandatory. "Each institution, whether a school or sports organization, has its own screening requirements, and in many cases may simply be a note from a family doctor clearing the athlete to play," he said. "In other countries, there is a formal, nationally mandated screening program to reduce the incidence of sudden death in athletes."

Last year, Dr. O'Riordan took a sabbatical to work with the  director of  Italy's national athletic screening program. In Italy, it is mandatory for all athletes, beginning at age 10 to12 years, to be evaluated annually by a sports medicine doctor. As a result, the country has seen a reduction in sudden death among its athletes.

At Lankenau, Dr. O'Riordan began his initiative by contacting team doctors and athletic trainers in the Philadelphia area, offering young athletes physical examinations, electrocardiograms and echocardiograms to identify those at risk for sudden death and to collect baseline data on the athletic heart.

After examining 100 athletes, two were identified to be at risk. One of the athletes, a runner, had a family history of hypertrophic cardiomyopathy, the most common cause of sudden death in athletes, according to various studies. In this inherited condition, the cells of the heart muscle enlarge, leading to disturbances of the heart's electrical conduction system and fatal arrhythmias.
 
"One problem in screening athletes is that we have not yet defined the 'normal' range for their EKG and echocardiogram, because of the changes in the heart associated with exercise and training at a high level," said Dr. O'Riordan. "Their numbers may fall outside the standard range, but could be entirely appropriate for their size and conditioning. This leads to difficulty in differentiating normal from diseased hearts in athletes."

Dr. O'Riordan said all athletes should see a doctor before participating in sports, particularly if they're playing high-exertion sports like basketball and football, the source of most sudden deaths in the United States. He recommends that children should see a doctor before they participate in sports starting at age 10 to 12. Family history is one of the most useful pieces of information in determining whether an individual is at risk.

"If I find a family history where the heart muscle thickens or is prone to rapid heart beats, that raises a warning flag because these are classic conditions predisposing young athletes to sudden death," he said. "Older athletes who die suddenly are more likely to have coronary artery disease."

Parents should be concerned if they have a family history of heart disease or if their child has symptoms such as profound lightheadedness, passing out, a racing sensation in the chest, severe shortness of breath, or chest pains.

"It's important to note that a sport itself is not a cause of sudden death," said Dr. O'Riordan. "Rather, it triggers the death in an individual who may have a pre-existing heart condition or cardiovascular disease."

For information about the athletic screening program at Lankenau Hospital, call 610-649-7625.

Published:11-2-2007