The Seriousness Of Sudden Death In Athletes

By Jon C. Walkes, M.D.
Updated: May 27, 2006

Jon C. Walkes, M.D.

Jon C. Walkes, M.D.

HOUSTON, Texas — The thought of an athlete dropping dead in the midst of a sporting event strikes fear in the heart of all sports enthusiasts.

We have all heard the stories of athletes such as famed college basketball star Hank Gathers who died during at the peak of his athletic career. The question is were there any warning signs or was there something that could have been done to prevent this senseless death?

The most common causes for sudden death in the athlete are hypertrophic cardiomyopathy (HCM), coronary artery anomalies and Marfan syndrome. Typically HCM causes enlargement of the left side of the heart and is an inherited condition.

As a result it is important that during a routine athletic physical exam one try to elicit any family history sudden death in the athlete’s family. The coronary arteries are the arteries that supply blood to the heart muscle. In a small number of people in the population there are abnormal sites of origin and routes of the coronary arteries that can predispose the athlete to sudden cardiac death.

Marfan syndrome is a genetically inherited connective tissue disorder which may lead to dilation/tear of the aorta. Patients with Marfan Syndrome are typically of tall stature, have long and thin limbs, have an arm span substantially greater than height, have diminished upper body-to-lower body ratio and long thin faces. In addition, they typically have hyperextensible joints and are able to overlap the thumb and fifth finger while encircling the thin wrist.

Oftentimes athletes that suffer sudden cardiac death do not have any warning pre-event symptoms. If they do, however, they may include exercise-related fainting spells or chest pain.

In addition, as previously mentioned, a family history of a sudden death should raise suspicion. Once the possibility of a problem is raised and EKG and ultrasound of the heart can be used to aid in the diagnosis.

The question of including the aforementioned tests in the routine physical examination of all club level athletes has been studied extensively and found not to be cost effective for athletic programs. The current evaluation of all athletes undergoing a physical examination should include: — Family history of premature or sudden death or heart disease in any surviving relatives.

— Personal history of heart murmur, systemic hypertension, excessive fatigue, exertional chest pain , exertional fainting episodes.

— Physical assessment for a heart murmur, examination of peripheral pulses.

— Parental verification of family history If you have any further questions or comment please contact Dr. Jon C. Walkes at