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Echocardiogram: a window to an athlete’s heart
03/29/2006
You’ve seen it on the news, you’ve heard about it before: a healthy student athlete suddenly collapses on the field or court and dies from sudden cardiac death. When heart function stops abruptly and without forewarning, you have to wonder if any preventive measures could have been taken. Many of the student athletes who experience sudden cardiac death have no previous symptoms.

Coronary artery disease usually is the reason for sudden cardiac death in adults. But if a young person dies from cardiac arrest, it’s more than likely he or she had an undetected abnormality in the heart. Having an echocardiogram is a reliable way to determine if a student athlete has certain conditions that could lead to problems during intense physical activity.

If your child has cardiac risk factors, his or her physician may order an echocardiogram to rule out certain cardiac conditions. The risk factors are:
• Family history of sudden cardiac death or unexplained early age death
• Repeated fainting during exercise
• Chest pain during exercise

“An echocardiogram is basically an ultrasound used to examine the heart, but with more extensive capabilities. For young people, it’s an effective tool for detecting certain cardiac abnormalities associated with sudden cardiac death,” says Palmetto Health Heart Hospital cardiologist C. Osborne Shuler. He is director of pediatric cardiology at the University of South Carolina School of Medicine.

“An echocardiogram can reliably detect two conditions that can lead to sudden death: hypertrophic cardiomyopathy, which is an abnormal thickening of the heart muscle, and dilated cardiomyopathy, an extremely enlarged heart,” Dr. Shuler explains.

An echocardiogram shows a cross-section of the beating heart, revealing the heart chambers, valves and major blood vessels. “Being able to determine the structure, thickness, movement, and pumping ability of the heart and major vessels is very helpful in identifying certain heart conditions,” Dr. Shuler says.

‘While an echocardiogram can help alleviate the anxiety athletes and their parents may have about possible risk factors, it is not a cure-all. There are limitations,” Dr. Shuler says. “Over the years, the quality of echocardiogram images has become more refined, so it can detect most heart defects, but the older and bigger a person is, the quality of the images and the chance of detecting an abnormality decreases.”

Palmetto Health is concerned about the startling number of sudden cardiac arrest deaths of student athletes. Therefore, an initiative was created to provide AEDs—lightweight, automated external defibrillators that can deliver the electrical current needed to restart a person’s normal heart rhythm after sudden cardiac arrest—to all middle and high schools in Richland, Fairfield and Pickens counties.

The initiative includes:
• Funding of AEDs by Palmetto Health. They are valued at up to $2,800 per unit, according to the manufacturer.
• Offering two types of required training at the schools, free of charge: four-hour CPR/AED training; and train-the-trainer sessions, which ensures someone at the schools can train others.
• Collaborating with the USC School of Medicine’s Sports Medicine Center to make recommendations for a comprehensive approach to health services for student athletes, which includes each school having a designated medical person.