Today, I am writing about a tragic physiological event that occurs too frequently in young adult athletes, sudden cardiac death (SCD), caused by hypertrophic cardiomyopathy (HCM). HCM is a heart condition that is caused by thickening of the myocardium, left ventricular stiffness, and mitral valve changes (“Hypertrophic Cardiomyopathy: Causes, Symptoms & Treatments”, n.d.). Often, patients with HCM can be asymptomatic and can live normal lives. Unfortunately, others with HCM may experience SCD, if they are thrown into a dangerous rhythm known as ventricular tachycardia (“Hypertrophic Cardiomyopathy: Causes, Symptoms & Treatments”, n.d.). Athletes are at particular risk from SCD secondary to HCM, as they stress their heart to a greater degree. HCM is particularly challenging to diagnose in young athletes as HCM often mimics similar EKG changes to normal left ventricular hypertrophy, which is normally developed with exercise (Malhotra et al., 2017). EKGs are not always effective for diagnosing HCM. HCM is instead often diagnosed by echocardiogram (“Hypertrophic Cardiomyopathy: Causes, Symptoms & Treatments”, n.d.)
SCD is particularly interesting to me as I was an NCAA division II cross-country and track runner during my undergraduate education. Throughout my student-athlete career I was surprised with the lack of cardiac screening that occurred despite competing in a highly straining aerobic sport. During college, I never underwent an EKG, much less any more advanced screening techniques to rule out any potential cardiac abnormalities. This experience of lack of screening however is not unique to me. Sadly, in the years between 2003-2013, 79 NCAA student-athletes died of SCD (Harmon et al., 2015). Despite this disturbingly high number of deaths, the NCAA still refuses to implement standardized cardiac screening for student-athletes. Instead, the NCAA recommends, but does not require, schools to perform EKGs (“NCAA allows schools to keep ECG screenings”, 2016). The NCAA also recognizes that schools across the country may not have the resources to properly screen their athletes (“NCAA allows schools to keep ECG screenings”, 2016). I do not feel that this mentality is acceptable, as the NCAA earned more than $1 billion in revenue in 2017, but at the same time refuses to participate in the safety of its student-athlete participants (Berkowitz, 2018). This poses an ethical question to whether the NCAA cares more about profits than the safety of its participants. I believe that the NCAA should implement a screening program that includes at minimum EKG screening, and potentially echocardiogram screening. Do you think that the NCAA should take a greater responsibility in its student-athletes’ health and fund cardiac testing?
Berkowitz, S. (2018, March 08). NCAA reports revenues of more than $1 billion in 2017. Retrieved November 15, 2020, from https://www.usatoday.com/story/sports/college/2018/03/07/ncaa-reports-revenues-more-than-1-billion-2017/402486002/
Harmon, K. G., Asif, I. M., Maleszewski, J. J., Owens, D. S., Prutkin, J. M., Salerno, J. C., Zigman, M. L., Ellenbogen, R., Rao, A. L., Ackerman, M. J., & Drezner, J. A. (2015). Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation, 132(1), 10–19. https://doi.org/10.1161/CIRCULATIONAHA.115.015431
Hypertrophic Cardiomyopathy: Causes, Symptoms & Treatments. (n.d.). Retrieved November 15, 2020, from https://my.clevelandclinic.org/health/diseases/17116-hypertrophic-cardiomyopathy
Malhotra, A., & Sharma, S. (2017). Hypertrophic Cardiomyopathy in Athletes. European cardiology, 12(2), 80–82. https://doi.org/10.15420/ecr.2017:12:1
NCAA allows schools to keep ECG screenings. (2016, April 16). Retrieved November 15, 2020, from https://newsarchive.heart.org/ncaa-allows-schools-to-keep-ecg-screenings/
I think its interesting that there isn't more awareness around this kind of condition considering the toll we already know that prolonged stress has on the body. Sadly, the world is no stranger to lack of screening until symptoms start to arise, however I think a change that could definitely be made starting with the NCAA require/fund this necessary cardiac testing in order to prevent their athletes from cardiac arrest. Especially since the NCAA already gains a significant revenue, the least they can do is take action to help prevent the deaths of the athletes fueling this revenue.
ReplyDeleteWhat is it that you think is preventing the NCAA from implementing this?
Hi Austin,
ReplyDeleteI find this topic very interesting, but also quite distressing. I know of several people who advocate to have NCAA DI athletes to be compensated for more than just an education, i.e. full healthcare benefits. Some of these athletes train very hard, and for long periods of time, in order to be able to compete at the highest level. At the bare minimum, I believe these multi-billion dollar institutions should make healthcare costs part of their scholarship package. Consider college-level football: those players are prevented from having any sort of financial benefits beyond scholarships, but are expected to risk their long-term health just to satisfy a program’s winning culture. Obviously, if a healthcare package were to get passed to give DI athletes another form of guaranteed compensation, I think the biggest hurdle it would face is “where are we going to get the money to fund this”. Its definitely a dicey situation, but one that I think will continue to get mentioned for the foreseeable future given the potential financial ramifications for both the student-athletes and cooperations. I personally feel that the article below really does a nice job going into further detail.
Thomas, Brennan. “Pay for Play: Should College Athletes Be Compensated?” Bleacher Report, https://bleacherreport.com/articles/654808-pay-for-play-should-college-athletes-be-compensated. Accessed 21 Nov. 2020.