Enlarged heart in athletes not uncommon
An enlarged heart found among athletes is not uncommon and may not lead to problems. The most common cause of death among athletes from enlarged heart is from hypertrophic cardiomyopathy.
The recent death of Gaines Adams, defensive end for the Chicago Bears who died this morning at age 26 brings a focus to cardiac arrest and enlarged heart. On Thursday, Jeron Lewis, a Southern Indiana University basketball player, also died from heart enlargement that puts athletes at risk for sudden heart rhythm disturbance.
In each death, enlarged heart was found on autopsy. Another name for the condition is hypertrophic cardiomyopathy that causes half of the sudden death cases involving athletes under age 35, and is different from “athletes heart”. Heart enlargment from hypertrophic cardiomyopathy is an abnormal thickening of the heart muscle that can cause heart rhythm disturbance and sudden death.
According to Richard Kerber MD from the University of Iowa, "In a majority of cases, hypertrophic cardiomyopathy is inherited and develops over time, typically in the late teenage years. Symptoms include black-out spells, unexplained dizziness, and chest pains that occur briefly during competition or training, but then disappear with rest.” For other athletes symptoms of enlarged heart may not be present, leading to sudden death.
Athletes are known to have enlarged hearts. It is the body’s way of adapting to intense exercise, and it is not a disease like hypertrophic cardiomyopathy. The condition can be found with a routine echocardiogram.
Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital explained in 2007 at a meeting of the American Heart Association, following the sudden death of marathon runner Ryan Shay, age 28,..."so-called "athlete's heart" thickens the heart muscle overall; hypertrophic cardiomyopathy creates thickening in one part of the heart and makes it harder to pump blood out to the body. One in 500 people have the disorder; some people have no symptoms."
"Sometimes it can be difficult to distinguish between these two conditions - one being benign and one being potentially lethal," said Mosca.
A study from Johns Hopkins published last year recommended EKG and echocardiogram testing for athletes, rather than EKG alone. One in five Americans has cardiomyopathy, or enlarged heart, that is undiagnosed. Researchers for the aforementioned study pointed out the importance for athletes to report symptoms of chest pain, dizziness, or shortness of breath that could be considered normal during intense training.
Enlarged heart in athletes from hypertrophic cardiomyopathy can go undetected even with intense screening. Hypertrophic cardiomyopathy can lead to sudden cardiac death from heart rhythm disturbance, and is the most common cause of death in young athletes associated with an enlarged heart.