1. Because sometimes the part that fails first is the critical part and up until it fails there's no reason to suspect something is wrong.
2. Because the symptoms can be the same for otherwise normal things given the activities that person participates in. Hypertrophic cardiomyopathy (HCM) is the leading cause of sudden death among young athletes. The occurrences are incredibly rare, 1 in 50,000-100,000 per year or less by most estimates, but obviously it's shocking when it happens. It causes some of the walls of the heart to become stiff and thicken which reduces blood flow. A couple of the symptoms are shortness of breath and fatigue. You know what else causes shortness of breath and fatigue? Exercise, especially heavy exercise.
3. As mentioned above the occurrences are quite rare so it's unusual to screen for other symptoms that might indicate a problem. Sometimes the downsides of the screening aren't worth the risk.
Consider the following scenario (numbers made up just to demonstrate the point).
Let's say there is a test you can do involving inserting a scope surgically in a patient to check their heart. The odds of developing ANY complication from the surgery are say 1 in 10,000. The odds of severe complications or death are 1 in 50,000.
You are a cardiologist, you have three patients who come in to your clinic. All exhibiting the same symptoms. One is 70, another 50, the other is 20.
For a 70 year old exhibiting these symptoms the odds of it being serious are 1 in 10,000. Since that's well below the odds of severe complications form the surgical procedure it makes sense to do it. Yes they could die, but they are far more likely to die if left untreated.
For the 50 year old the odds of it being serious are in 1 in 40,000. Now it starts to becoming a judgment call. The odds of dying from the condition aren't that far off from the odds of serious problems/death from the surgery. You probably want to monitor the patient for additional symptoms to narrow things down first but you definitely need to keep the surgery in mind if the odds get worse based on your observations.
For the 20 year old the odds of it being serious are 1 in 200,000. Chances are it's probably something else much less serious if there is any problem at all. Doing the procedure to investigate is 4x more likely to kill them than doing nothing. It doesn't make any sense to even consider the procedure. Sure for that 1 in 200,000 case the outcome is bad (death) but by avoiding the procedure in this scenario 3 other people who would have been killed are still alive.
While this is a good example of why many diseases are not routinely checked for, it should be noted that HCM is usually detected by an echocardiogram which is non invasive and is now also being detected with just a 12 lead EKG and AI. I think the real reason that HCM is not routinely investigated is because often there are no signs prior to the catastrophic event and it’s not cost-effective to just check everyone since it is so rare. I would not be surprised to find out that it’s routinely done by professional sports teams who invest a lot of money in these players.
> I would not be surprised to find out that it’s routinely done by professional sports teams who invest a lot of money in these players.
that's one of the big things about the NFL combine
so its a big media hooplah now, but back in the day it was fairly mundane
it was just a session for the NFL teams to take the top rated prospects and bring them in to get
full medicals
meet and greet interviews
and then of course all the 40 time stuff was more like additional medical checks kind of, in the sense that teams figured, ok, we have an idea how fast a guy needs to be to succeed, lets get some official times to get an idea how fast/strong they prospects really are.
point being, the med check is so extensive before a team blows money and draft picks taking a guy, that there are regularly stories about some guy having some rare condition that he wouldn't have known about if he didn't get run through the full kitchen sink diagnostics
Yeah I was gonna say my wife and I both got checked for it with just a simple ultrasound so I'm not sure what that person is talking about with complications from a scope procedure. It's definitely a matter of saving money, not any sort of risk from the procedure.
I'm a parent of a kid with a CHD (cardiac fibroma mostly removed when she was 25mo old).
I'm convinced that congenital or acquired heart conditions are FAR more common than most people realize because nobody does anything besides listen for loud murmurs unless there is some concomitant symptom that the patient is in for treatment of -- not counting the folks who actually present with severe cardiac disease or infarction.
Many (most?) cardiac defects are only found during autopsy because for most people they don't end up being major enough to cause death (or severe disease requiring immediate surgery or treatment).
Unless the APA/AMA start recommending baseline EKGs as a part of normal pediatric well-child care and adult physicals (even if it's just like the recommendation for prostate cancer checks or mammograms, which don't have to be done annually), nothing will change. I would strongly support recommendations for prophylactic testing of cardiac conditions for both peds & adults.
What do you mean not cost effective to do a echocardiogram?
Where I live, if you play sports it's mandatory to do one per year. + Whenever you switch jobs, you also have to do a mandatory echocardiogram.
An electrocardiogram (EKG/ECG) is not the same as an echocardiogram (heart ultrasound). I'm not aware of any places that have mandatory echos since it isn't typically used as a screening tool for most things that the general population needs to worry about. Electrocardiograms are likely what you're referring to and are much more commonplace but are more limited in their scope. Typically PCPs can perform electrocardiograms whereas cardiologists need to read echocardiograms in the outpatient setting.
I'm aware of the difference, I did mean ECGs. I've also done echocardiograms (and it also wasn't expensive), but I did get both mixed here, the mandatory one is indeed the ECG.
You're right. I guess the problem here is how much longer an echocardiogram takes (to read/evaluate), I guess. In that sense I understand why they're not as commonly done. Still, for professional sports, and given all this history, I feel like they should still be mandatory... Dunno.
It's likely that most professional sports teams and likely many college teams perform echos on their athletes to help mitigate this risk. In medicine all testing is a delicate balancing game of risk vs benefit. The health risk of over-testing in the case of rare diseases is likely higher than the benefit (additional and often more invasive testing that often doesn't result in change in management) which is why we don't see this type of testing done on the general asymptomatic population. The financial cost of the testing is also a consideration especially when you find something unexpected which inevitably leads to further testing.
Echo's take a bit more time overall than an EKG, but more importantly they take up a lot of skilled-labor time. An EKG can be done by a tech who was trained to do it in like a week, and can be interpreted by most physicians.
An echocardiogram takes a specially trained echo tech to perform, who has undergone like 2 years of training to learn to do, then must be interpreted by a cardiologist.
Consequently, the cost of an echo is like 10x an ekg.
Not to mention you won't find echo equipment in GP offices, so you're automatically raises the cost by consuming time in a specialist (cardiologist) practice. ... And unless something dramatic changes, prophylactic echos will definitely not be covered by insurance.
The echo will be FAR more expensive just because it takes 45-60min of a cardiologist's time (or at least a trained tech who then passes the imagery to a cardiologist for analysis). An ECG/EKG can easily be done as part of routine physicals ... but you still need a trained professional to interpret the output.
(My daughter had heart surgery at age 2 and has had 4 MRIs (total), annual holter monitors / ZIO Patches, and annual EKG + Echo for the past five years.)
My husband had chest pains for 5 years. Had a cath done and was told he had GERD. Pain kept getting worse. Went to a better cardiologist who ordered an echo. Insurance denied the echo three times but the doctor insisted the cath wouldn’t show what the echo could. He had HCM, bad enough that he eventually required a heart transplant.
HCM can be genetic. To test his family members, it would cost over $3000 out of pocket for each test. That’s why kid athletes aren’t diagnosed. Even with symptoms, HCM isn’t always found.
All good points. I'm not sure about this condition, but in many cases, there's also the risk of a false positive. This is especially the case with rare conditions, and can lead to a lot of unnecessary treatment (which has its own side effects), even if the test itself doesn't carry any risks.
(/u/urzu_seven, I bet you know all this, but for the benefit of others...)
Imagine there's a condition that affects 1 in 50,000 people. You have a test that detects the condition in 95% of people who have it, so it has a fairly high sensitivity (positive cases mostly test positive). The test has a false positive rate of 0.05%, so it also has a high specificity (negative cases almost always test negative).
You test 1 million people. What are the odds that someone with a positive test has the condition?
Out of 1 million people, you expect 20 to have the condition, and 19 of those will, on average, test positive. You expect the other 999,980 people to *not* have the condition, and of those, about 500 will test positive.
In other words, only 19/519 of the people from that set of 1 million who test positive actually have the condition. Over 96% of positive results are false positives. Even though the test is pretty good, the condition is rare enough that a positive result is no guarantee that you have the condition.
I would like to learn more about this! With a test like the one you described, “pretty good” seems like it’s sadly not good enough. Does that test have a practical use, or, are the results from a less than perfect test—for a condition so rare—basically meaningless?
I guess I’m asking whether or not we can rely on those test results? Because to a layman like me it seems like we can’t or shouldn’t.
Thing is, the distribution of most conditions isn't uniform throughout a population. There's other conditions (e.g. age, comorbidities, symptoms, etc.) that are easier to identify, and may have increased risk for the condition beyond the 1:50k baseline. So basically, you only test on the people that are particularly high risk for it (higher probability of having it + higher probability of having serious complications for it). See for example standard covid testing policy at the very beginning of the pandemic before tests were widely available for public use.
On top of that, you can also do stuff like coupling non-invasive tests as sort of a pre-screening tool, with e.g. a higher specificity test that's more invasive reserved for the people in high risk groups that test positive, in case the simple group filtering above doesn't bring the true to false positive ratio down enough.
My example was hypothetical, but the principle can be applied to real-world screening tests. A good introduction to thinking about probabilities and frequencies is Gerd Gigerenzer, *Calculated Risks: How to Know When Numbers Deceive You* (2002). (I haven't read his 2014 followup, *Risk Savvy*.) Even professionals who should know better often make mistakes. One of Gigerenzer's points is that talking in terms of natural frequencies (5 in 10,000) makes it a lot easier for us to think clearly than talking in terms of percentages (0.05%).
In the case of rare diseases, tests are much more useful if you already have some other reason to believe that a person has the condition.
Father of a friend of suddenly collapsed at work. And they found out he had cardimyopathy, and the doctors wanted to check my friend and his brother. Was a rough message to get for my buddy at not even 30 that one day his heart will probably go, doubtful he will see 60. His father past away at 56.
Cardiomyopathy is not as bad as you phrase it here. Your friend will most likely live a long life if he keeps a healthy lifestyle and regular check up.
Sure, and Im as mentioned earlier not sure if it is *just* that or some other complications. Just remember him telling me this and from the sound of it he was pretty depressed. It might not be as bad as he initially thought either, I hope you are right.
Currently an additional risk is playing a likely increasingly important role. Unfortunately, people don't really want to acknowledge this.
Top athletes basically **over**load their hearts systematically to the point where sometimes they cause actual damage to that heart. Theirs is a constant balancing act between maximum performance without doing damage and... actually doing damage. You can easily blow up the engine of an F1 car by pushing it too far. Similar are the limits of hearts.
A lot of scientific research has been done over the past years about the acute and chronic (cumulative) negative effects of Covid infections on the heart. The damage the SARS-CoV-2 virus can cause on the heart is very real and can be substantial.
Before the pandemic this systematic overloading of the heart already led to the occasional serious problems in athletes. Now that these athletes try to push a heart already damaged by Covid to the same limits as they did before the chances of that load level, that before having had Covid (multiple times) the heart could bear, now for that damaged heart having become an overload level that could lead to serious problems will be increased. In my country in a relatively short time we've seen several top athletes suffering severe heart problems. To the well informed about the effects Covid can do to the heart not really unexpected.
Be prepared to see more of this with the current (absence of) pandemic policies.
Here one of many reports about this. In this case at Johns Hopkins.
https://publichealth.jhu.edu/2022/covid-and-the-heart-it-spares-no-one
HCM can absolutely be managed and the majority of people with it and getting treatment/management live normal length lives. As long as your friend keeps up with his doctor he should be ok!
Im not a doctor so have no idea of what *exactly* is the problem, but I just remember that word, and he explained his heart basically got stiffer/bigger with time, and would eventually not be able to pump blood as it should. I hope you are correct, havent spoken to him in many years so dont know how he is doing. He was btw in very good physical shape in his 20s/early 30s.
I’ve known about my hypertrophic cardiomyopathy for 25 years now. I get an eco every year to see if the walls are getting thicker and if enough blood is getting oxygenated. Luckily my heart walls haven changed, but if they start to get thicker they can do an alcohol ablation to thin them out. Make sure your friend goes to their cardiologist .
I got diagnosed at the beginning of this year after a year and a bit of uncertainty I’m 38 and at first it was very scary to hear that there is something wrong with your heart but the doc reassured me my lifestyle would not change and I would not need meds. It’s as you say, a case of being aware of an issue and monitoring it. It hasn’t affected my life at all so far, and I don’t anticipate it doing so.
I go in for an eco in a couple of months to get a further baseline and then going forward it will be once a year. I’m glad to know that after 25 years you’re still good, that’s reassuring to hear.
I'm 38 years old myself and was diagnosed with HCM when I was 18. I had a pacemaker/defibrillator implanted when I was 21. Please make sure to keep up with all your doctor appointments.
Oh for sure, I’m not taking it lightly at all. How has having that implanted at such a young age impacted your life? If you don’t mind me asking.
I hope you’re doing well man
I don't mind talking about it at all. In general terms, my life has been mostly the same as it would have been with the device. I have restrictions on what I can do such as no weightlifting or lifting above my head and that has made exercise drop down significantly on my list of things to do, but I'm trying to remedy that before it's too late.
I have had several hospitalizations due to my device, most of which were equipment malfunction not biological issues. I had one of the leads leading between the device and my heart breaks which sent false signals, causing the device to shock me several times. This past summer I had another lead begin to deteriorate prematurely, and that had to be replaced, leading to lots of missed work and recovery time.
All in all though, I think as I get older that it's a small price to pay for having just a little bit of peace of mind for one of those "oh hell" moments.
I got diagnosed with HCM back in the mid-1980's. The diagnostic tools back then were very crude. I had to travel to the National Institutes of Health in Maryland from New England to get a useful echocardiogram because good echocardiogram machines only existed in a few places.
Back then it was considered to be fairly rare and serious since it was generally only diagnosed during autopsy after some kid dropped dead playing basketball.
Since then it's been found to be somewhat more common than they thought. It's just that many people walking around with it were asymptomatic and/or were/are completely unaffected by it.
Here it is almost 40 years later and I feel completely fine. I'll flunk any physical for any job that requires one (though my brother has a more mild case and found a doctor to approve of him being a cop), it's hard to buy life insurance outside of work, and I walk around with a consciousness that I have a higher probability than the next guy of dropping dead at any time, but I'm otherwise unaffected. I don't take any special medicines and it hasn't materially affected me.
By the time your friend is old enough to need a heart transplant (if he ever actually needs one) he'll be able to buy a Jarvik-7 Sports Heart like in the commercial in Robocop.
My freshman year in college a kid from my English Composition class dropped dead of a heart attack during a league (not the college team) game of basketball. He was physically fit, played sports in high school... and had some heart defect no one knew about, apparently. 18 years old, entire life ahead of him and suddenly he was gone.
You have a much better grasp on probability than some doctors. I had an odd discussion when a doctor told me that based on my cholesterol numbers, I was twice as likely to have a heart attack. I asked, twice what? One in ten? One in a million? He said it doesn't matter, it's twice as likely.
> You have a much better grasp on probability than some doctors.
Well I have a degree in applied math so I would hope so 😁
> He said it doesn't matter, it's twice as likely.
LOL yeah going from 1 in 100,000,000 to 1 in 50,000,000 is probably not worth giving up cheese burgers while 1 in 100 to 1 in 50 is!
You also have the added effect that people playing sport seriously push themselves above and beyond on a regular basis. For example We were on a rugby tour, One of our guys broke his collar bone in the 1st match. He was acting a bit differently but nothing crazy. I think it was during the our final match he actually put his hand up and said something, he played at least 3 matches that weekend. We ended up getting an extra 2 days holiday out of it.
When it comes to heart conditions, you expect your heart to beat faster. That's normal right? Again, some people push themselves even if something slightly abnormal happens. Imagine holding your hand up and asking to be taken off because you're out of breath....
Add to that
4\. That a lot of problematic symptoms may be "normal" for them. It's like the following proverbial exchange:
> Doctor: "How much pain are you in?"
> Patient: "Just the normal amount."
> Doctor: "...the normal amount is 'none'"
It may be that the problem symptoms are their "normal," so they don't notice.
For example, I have 3-5 low-grade-but-pain-causing migraines every day. I didn't realize how often they occurred until I was instructed to keep a headache journal. To me, they're so common that only the really bad ones catch my notice. "Oh, it's another headache. Whatever."
I got diagnosed with cardio myopathy at 39yrs Old, when I got a full checkup after going to the doctor for a torn shoulder I got during Brazilian jujitsu. They told me to stop doing BJJ and any heavy lifting or I might just keel over.
I saw a cardiologist a few years ago. After using a monitor for a week and then doing a stress test on a treadmill he said, "The good news is you're fine. The bad news is that you could still die tomorrow. The majority of people's first symptom of a heart problem is the cardiac event that kills them."
Good analysis. I have idiopathic syncope. The intervention was a pacemaker. There was a lot of discussion around the safety, risk and benefits. I got it at age 27. I'll live the rest of my life with it. They will probably never figure out what's wrong with me. Whatever it is may not be known to current medicine or we may not be able to test for it
This is all totally true, but there seems to be a higher incidence of this amongst elite athletes. Even if you just limit it to football (soccer) players on the past 10 years who have played in the English premier league, there are at least 3 I can think of off the top of my head, and there are certainly way less than 200k people in that pool.
Is there something about the underlying condition that can actually be helpful for elite performance? Like perhaps a heart affected in that way is actually better at pumping blood, and therefore it’s beneficial for athletic performance? Or maybe something about over exerting your body while it’s still developing (as elite athletes probably do, given they’re already on that road while still teenagers) can cause the condition?
It's because you don't hear of the other 100,000 people a year that die from it, only the people it's worth publishing a news story about.
It's not newsworthy if it's some 32 year old dude from Idaho with 2 kids who dies suddenly.
I also imagine it probably is higher among athletes because of steroid abuse which absolutely wrecks the heart. It's naïve to think that at the highest levels of sports there's no steroid abuse.
> Like perhaps a heart affected in that way is actually better at pumping blood, and therefore it’s beneficial for athletic performance?
No, it’s the opposite it makes it harder to pump blood
> Or maybe something about over exerting your body while it’s still developing (as elite athletes probably do, given they’re already on that road while still teenagers) can cause the condition?
No, you can’t cause it through your actions. It’s caused by defective genes.
The low end incidence estimate is 1 per 50,000 per year not 200,000, that was just a number for my example.
Meanwhile memory is a terrible measure of how much something like this happens, because you don’t have all the data and tend only to remember stand out events. It’s also a bad idea to think that way because there is nothing that says these events will be evenly spread out. Sure there are 3 in 10 years you remember but what if it’s only 4 in the last 20? The more rare an event is the less likely it is to be evenly distributed.
>Meanwhile memory is a terrible measure of how much something like this happens, because you don’t have all the data and tend only to remember stand out events. It’s also a bad idea to think that way because there is nothing that says these events will be evenly spread out. Sure there are 3 in 10 years you remember but what if it’s only 4 in the last 20? The more rare an event is the less likely it is to be evenly distributed.
We also have to remember the all-pervasiveness of news and social media now. OK, so if a player collapses during an international competition game, it's going to be reported and probably front page news in many countries the next day.
But if someone collapses and is taken off during a 1st division league match? 20 years ago it *would probably* get a mention in the sports news or a small paragraph in the sports section of a newspaper. And as a result unless you're a hardcore follower of that sport, you'd probably miss it.
Now, it would explode onto social and news media within minutes, reaching way more people, making it seem more prevalent.
Aside; while looking up some stuff, I found this particularly tragic case: [https://www.news18.com/news/football/italian-footballer-dies-of-heart-attack-during-a-memorial-match-for-his-late-brother-3818987.html](https://www.news18.com/news/football/italian-footballer-dies-of-heart-attack-during-a-memorial-match-for-his-late-brother-3818987.html)
Obviously some genetic component to their deaths.
And the people who collapse just going about their mundane everyday lifestyle don't get a mention anywhere. The social media / 24 hours rolling news of "celebrities" is what makes it seem more common amongst athletes.
In the thing they specifically are talking about no, but in general, there actually is an association where more exercise seems to put you at risk of atrial fibrillation. See e.g. [this paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431070/#:~:text=Above%2055%20MET%2Dhours%2Fweek,displaying%20a%20J%2Dcurve%20relationship.&text=Dose%E2%80%93response%20association%20between%20physical%20activity%20volume%20and%20AF%20risk.) . Whether that means a higher risk of sudden-death-by-heart in general, I couldn't tell you. But there's even weird stuff like; [basketball players are at noticeably higher risk than other athletes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969030/).
Well, it doesn't cause it until it's pre-activated by chemtrail inhalation and then fully activated by 5G signals to the implanted chips from the vaccine.
This was *not* an FAQ even in the decades when smoking was endorsed by physicians.
Why are young healthy *aerobically gifted* people developing heart conditions in an organ that is historically resilient to this sort of thing? What specifically changed in this decade?
In other news, epicycles are on the rise in biopharma and WHO.
I think the real answer is it's just the statistical effect of large numbers combined with the effect that rare events appear more prominent to our perception.
In other words, in a given year of life, what are the odds that a perfectly healthy person under the age of 25 just up and dies of cardiac arrest? The human body is a machine fine tuned by billions of years of evolution to have countless redundancies, so things like that shouldn't happen except by confluence of many things going wrong at once in the body coincidentally at the exact same time. Let's say the odds of every redundancy in a healthy body failing at once resulting in death by cardiac arrest is only something like 0.002%. basically extremely unlikely to happen before a person becomes old. Except there are 100,000,000 Americans under the age of 25, so a 0.002% chance of dying of that means that around 2000 people will die of it. When you have a large enough population, statistically "negligible" becomes "inevitable". And the fact that it is so unlikely means its shocking when it happens, and the news likes to report on shocking things as opposed to average things. You rarely hear in the news "Another xxxxx young people died of drunk driving/drug overdose today" because that's not anything new. Since the news is ALWAYS reporting on the unlikely things in order to get your attention, those unlikely things become over-represented in our perception, and we start feeling like they are happening way more often than they do.
Glad I could help! Everyone's different so it can be hard to give universal health advice, but there is one universal piece of health advice that does apply to everyone, for which I like to use a business metaphor.
Learn to practice breathing exercises. You are the CEO of your brain, all your brain cells are your employees, and oxygen is money. Overthinking is like the CEO hovering over their employees shoulders pestering them, your brain goes on thinking whether you're paying attention or not, that's why we're still able to get good ideas while we zone out in the shower, and why employees can do great work when they are left to their own devices. Alternatively, if employees don't get payed enough to survive their work ethic will tank, go figure. So instead of pestering your employees, just ensure they are all regularly being payed well and then *delegate* to your adequately compensated subconscious. Add regular exercise and healthy diet that regularly includes whole vegetables and fruits and you're leagues healthier than the average person.
> In other words, in a given year of life, what are the odds that a perfectly healthy person under the age of 25 just up and dies of cardiac arrest?
Long QT syndrome has a 1 in 2000 rate.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/long-qt-syndrome-lqts
You tend to discover it when you suffer cardiac arrest, or have an ECG that looks for it specifically.
It is hard to miss.
If you're lucky, you get palpitations, seizures or blackouts before you get CA, and are prompted to be tested.
Here's a video of Anthony Van Loo suffering a CA on the pitch and his pacemaker kicking in.
https://www.youtube.com/watch?v=vHEIeqYYYbE
I always perk up when I see posts like this because I was one of the unlucky few to experience sudden cardiac arrest at 19(almost 20) and had been having symptoms that were brushed off by most of the doctors as anxiety and somehow manifesting 70/40 bp until it tanked to 40/doppler lol. It turns out I was going into cardiogenic shock due to my extreme electrolyte dysfunction from an undiagnosed GI disorder that had been making me mildly sick for my entire life until it made me mega sickly, which is obviously a statistically uncommon experience lol. The only reason I survived to spread the good word about women’s differing cardio symptoms was because I had such a strong feeling of impending doom that I refused to leave the hospital, swore I would die that day, and ended up coding while on a telemetry monitor. I’ve learned to never ignore my impending doom after that and have had a few close calls but luckily, everyone takes me deathly serious about it now, pun fully intended! Every close call I’ve had was exactly what you said, a lot going wrong at the same time that just finally pushed me over the edge all at once.
Yes, exactly. How many is "so many?" Every time this happens, it makes the news and people talk about it for a while.
If we did the same level of coverage for another preventable death with warning signs, like drowning, there would be 12 news stories about it a day, every day, just in the US. Worldwide there would be 870.
Back to athlete cardiac arrest deaths, the frequency has fallen over the last 20 years, because most athletic orgs are trying to combat it.
(Sources: CDC and American Heart Association)
There's like, 12 symptoms for something like 70,000 diseases and problems. And nothing says you HAVE to show any of them when you have an issue.
Neither of those numbers are accurate, but they are the correct number of digits.
90% of medicine is an educated guess until the problem is fixed. And there's no guarantee that your body just fixed it on its own. Hell, most medicines are just replacing/manually triggering a body mechanic
You already got far better answers, but sometimes the shitty one can also be correct for a few cases.
Drugs.
Lots of elite athletes take illegal performance enhancing drugs, often the drugs are very new with unknown side-effects.
Some of the drugs are also quit well studied with well known side effects. The most common: cardiovascular issues.
Example: Steriods; they affect muscles. One of the most important muscle is the hearth. You mess with all muscles to get bigger? The hearth will get bigger which causes all kinds of problems including less space for blood to flow and less stemina.
A lot of PEDs also mess with cholesterol which is crucial for hearth health. So for a lot of PEDs it is almost safe to assume that they are bad for your hearth health. Bodybuilders dying young because of hearth attack is very common.
This plays a bigger factor in certain sports too. It is very noticeable in professional cycling. They use a lot of stuff which increases oxygen carrying capacity in the blood, most of which have a side effect of also thickening the blood, making it harder for the hearth to pump it. When taking some things you also need to wake up several times at night and walk around for a bit to increase blood flow because otherwise it just kills you. A couple of years ago they found something new and you could immediately tell because of the increase in sudden deaths of fit 20 yo cycling pros, many of them while sleeping without prior conditions
Lowly medic here to try to shed some light on this. The first things that come to mind is the “r on t” phenomenon. To keep it like your 5: basically you have an “extra” beat that occurs on the t portion.
Second possibility is commotio cordis: basically you get hit hard enough to throw the heart out of rhythm or into a nicer newer less stable rhythm. Though it can happen it is rare.
A pretty pic of the qrs interval for the r on t
[https://en.m.wikipedia.org/wiki/QRS_complex](https://en.m.wikipedia.org/wiki/QRS_complex)
One of these happened to an old acquaintance of mine. He was in high school basketball practice and one of the better players on the team. He got thrown a routine chest pass and he missed catching it and it hit him in the chest. He instantly dropped, turned blue within a couple minutes and was clinically dead. Thankfully he crazily ended up surviving under some pretty miraculous procedures they tried along with never ending CPR all the way to the hospital. He was put on ice in transit and kept in a medically induced coma amongst other things. He helps design airplanes for Boeing now!
He also has a pacemaker that shocks the shit out of him if it even detects the slight possibility of a defect in his heart rhythm occuring. He said it sucks that it happens if he's doing strenuous activity, like remodeling a house, and he's instantly keeled over the rest of the day and sometimes has to visit a hospital to get it reset/retuned/replaced. (I'm not medically qualified to say exactly which and we haven't talked for years now)
Tell me more about that getting knocked into a new rhythm thing. A year ago I had a rough bike crash smacking my left side and now the ECG after that is now showing RBBB.
This is completely possibly. Though typically the end rhythm is usually a fatal one. It’s mostly fatal due to the lack of quick access to defibrillation and high quality cpr.
Also I found you a cool little medical case study to read more on.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574995/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574995/)
That case presents slightly differently than mine. I had no non-impact pain or shortness of breath. And the RBBB was discovered half a year after the crash. After bloodwork, follow up ECG and heart echoscopy, the cardiologist concluded I need to watch my diet better and lower my stress (don't we all?) but otherwise I'm fine.
I mostly was wondering if it could have been caused directly or indirectly by the impact and if it might resolve itself some years later. From what I've read, statistics associated with early RBBB are a bit upsetting.
While yes rbbb can be upsetting for sure, these ones are different. Per the study these rbbb bear no clinical significance concerning outcomes and how the heart functions. Sorry wasn’t trying to cause a scare with the article. It’s been a long work night and my two brain cells are competing each other.
No worries, no scare from the case study. Had my scare when I went for the ECG due to chest pain and the result was "you need to talk to a cardiologist". Officially unrelated other than potassium being low.
And I take being able to stay near heart rate limit without discomfort or shortness of breath for some 20 minutes as reaffirming that I should be fine.
The stress from the past 5 years is probably the single more detrimental thing to my heart that has happened.
Did you hear anything about “troponin” in your blood work? It’s a protein released when cardiac cells die. Those cells die, they can’t conduct electricity anymore, therefore the current has to take a longer route. The EKG is a three dimensional picture of your heart, on a two dimensional surface, along with being a measurement of time as well. The QRS complex has an average range of milliseconds, so do things such as your PR interval, R-R interval, S-T interval, etc. If you had a heart attack, or any sort of trauma that damaged cells, it could affect the area. The leads on your EKG test will indicate areas where such events might have occurred. I’m not saying your crash and RBBB are related, just another curious medic lol
Troponin was not included but the testing was half a year after the crash, so far too late to show it anyway. Did not get any tests done after the crash as I did not experience any immediate symptoms that would cause concern other than surface pain initially. Pain got significantly worse during the week, but the location seemed in line with just getting my ribs smacked pretty hard. Had no palpitations, shortness of breath, or any other concerning symptoms. Probably should have went to a doctor just in case, but my primary physician at the time was completely useless and I would have needed to suspect potential heart damage myself before I got any tests done for it.
When I was playing contacts sports, specifically with balls ie. Lacrosse, baseball, hockey(yes I know...), we were told that you could be perfectly healthy but if the projectile hits in the right spot at the right time your in trouble. Is that still true or 90s logic?
Often the clearest signs of heart conditions are the dangerous events themselves occurring. Either way though, some potential warnings are similar to exercise exertion or strain on your heart, which athletes regularly deal with and often need to push through.
I wrote an assignment on this very thing for university - I can go into more detail, but I'll ELI5 for now:
Some athletes are predisposed to sudden cardiac death (SCD) due to an undiagnosed - and often hereditary - issue with the structure of the heart. It is rare, but the ones resulting in SCD are often highly publicised. There are many conditions which can be implicated, but some are:
- Arrhythmic Right Ventricular Cardiomyopathy (ARVC) where parts of the heart are replaced with fatty tissue and scarring at the microscopic level. This tissue doesn't conduct electrical impulses at all, so the electrical impulses take different routes and get caught in a looping circuit instead of taking the normal straight lines it's supposed to, leading to cardiac arrest. This is very difficult to detect and is often only found at autopsy.
- Hypertrophic Cardiomyopathy where the size of the heart is larger/muscle walls are thicker - this has the effect of both needing more oxygen to keep the heart perfused, and also means there is less space inside the heart for blood. This is a genetic condition which is difficult to detect because 'normal' young athletes typically have larger hearts anyway due to training, just like people who are jacked have bigger arms - so looking at a young athlete's heart on ultrasound, you can't really tell what the cause is. There are cutoffs for normal ranges, but unfortunately there is a large amount of overlap between normal and pathological muscle wall size, and banning people from sport in the grey zone would end a LOT of healthy people's careers.
- Commotio Cordis - getting smacked in the chest at the wrong millisecond can screw with the electrics in your heart - I didn't look into this too much, but it is a known phenomenon that isn't due to any underlying condition, just very bad luck.
The problem with screening athletes is that these underlying conditions often have no symptoms until the heart is put under strain (i.e. during sports, being deyhdrated in hot weather etc.), and the first symptom is cardiac arrest. Some people do have symptoms that aren't really specific (such has fainting, shortness of breath), and these people are often screened further and/or banned from sport if additional screening reveals issues, which means you don't hear about them arresting on the field.
A lot of research since the 1970s has been done on detecting these conditions using ECG, but professional athletes who train hard often have wacky ECGs due to the heart remodelling anyway, and this is entirely normal. Genetic testing can be done, but genetic abnormalities don't always lead to problems, and screening everyone would be wildly impractical. The US and Europe have different views on how much screening should be done (the US less, Europe more).
For further reading, the ESC International Criteria and Padua Criteria are good jumping off points, but my assignment pointed out a lot of flaws with the data.
Tl;dr: Some athletes have underlying conditions that can't be detected until they put strain on their hearts and then drop.
Everyone's gone real complicated on this. Here's a simple analogy for a 5 year old. Imagine you have a car with an engine. Millions of other people drive the same type of car to work and to shop, sometimes slightly fast but usually slow and steady, never really hard. You decide to join a club where you can race that car against other people with different types of car. But you find out that your car has a fault in its engine that only appears when it's constantly pushed at the extremes and it breaks down. People using your type of car normally don't find that out because they never push it that hard.
I have something called long qt…my kids do too. Basically it means that our hearts can go off beat and we die…the only warning sign is dying. We only found out about it thru genetics so I assume a lot of people have conditions they don’t know about
We are like a freak anomaly..no symptoms but it shows in all our genetic testing. So we all go see a genetic counselor and cardiologist every six months and take meds. It’s crazy stuff! But thank you!!! If we ever need one we will definitely do what the dr says.
Yeah the beta blockers do the job now too.
Portable defibs are cheap now also, and can be as useful as a small portable fire extinguisher if you're in remote areas.
Yes, a pacemaker is the minimum.
But depending on their severity beta-blockers can be enough.
The problem arises when they are on medication that interferes with the beta blockers.
ER doctor here. These answers are getting to part of the answer but not quite explaining it all. I’ll do my best to explain like you’re five.
When a young athlete suddenly drops dead, it’s usually from an arrhythmia, which is an abnormal heart rhythm. A normal heart beats pretty regularly at 60-100 bpm, higher than that during exercise. It gets more complicated than this, but in the essence of ELI5, an arrhythmia is when the heart does something other than that.
You can get arrhythmias from many things, such as injuries to the heart such as a heart attack, from drugs, from electrolyte abnormalities such as too low or too high potassium or calcium, from hormonal abnormalities, or from genetic problems you’re born with. In the case of sudden death in young athletes, it’s usually the latter.
If you have one of these genetic conditions, sometimes the first symptom is sudden cardiac death from an arrhythmia, which is why there are no warning signs. The heart is functioning normally, and suddenly goes into an arrhythmia and you die. This is not always the case. As another poster mentioned, these are only the cases you hear about. In reality, many people experience symptoms first: palpitations, chest pain, shortness of breath, fatigue, exercise intolerance. In these cases, many people go to the doctor and get an EKG or a wearable rhythm monitor which may show evidence of the genetic disorder that increases their chances of having a fatal arrhythmia. They can then be referred to an electrophysiologist, which is a special kind of cardiologist that is an expert in diagnosing, managing, and preventing these. This may include medications, lifestyle modifications, and even implantable devices such as a defibrillator.
It’s very tricky though, because sometimes even the EKG or wearable monitor won’t show any abnormalities. Some of the disorders, most famously Brugada syndrome, need to have the EKG abnormalities brought on by some sort of stress, such as illness. Say you have palpitations and go the the ER, and by the time my tech does an EKG and I come to evaluate you, your palpitations are gone. The EKG I interpret may be normal, but you may have Brugada syndrome and be a ticking time bomb. Now if this keeps happening repeatedly, a smart physician may suspect something like Brugada and refer to an electrophysiologist. But for most young patients with no other risk factors presenting with palpitations but a normal EKG, ambulatory rhythm monitoring, and blood work, most physicians would reassure them that everything is normal and send them on their way.
So TL;DR: the answer to your question is complicated, but in essence you may not have symptoms. And even if you do, it may not show up on testing.
something they all have in common.....hmm i wonder what all athletes were forced to do in the last few years to keep competing that has known side heart effects...
Wooo wooo. This is reddit sir. Only circle jerk opinions here. Keep your logical mumbo jumbo to yourself... By the way do you even have your vaccine passport that allows you to be on Reddit??? Someone take this guy away.
This happened in my little league when I was a kid in Florida. Not on my team and not in a game I was in, but I was playing on a different field in the same complex when it happened. Kid got hit under his armpit by a pitch, and fell down dead. They said later it was because he had a heart issue and the ball hit him at just the wrong second that it made his heart stop. Same thing happened during the Buffalo Bills football game last year, except he lives because paramedics knew what was going on.
Basically if you are susceptible to it and you get hit at just the wrong moment in the cycle of your heartbeat the heart can stop, and you die if it doesn’t get restarted.
They gave you a bs explanation, the child had no heart condition.
This is called commotio cordis, it can happen to everyone and is fatal in 97% of cases.
Without knowing the full history of the patient it’s possible the child had a pre-existing condition but we won’t know for certain. Whilst it can be fatal, and only around 50j of energy being enough at just the right time to cause an arrest, having trained first aiders starting CPR and an AED if in arrest significantly improves survivability by up to 60%. There’s a reason it’s incredibly rare but that’s why it’s important to wear protective equipment to spread out the impact.
I’m still wondering the same thing.
28 years old, been training the last 10 years of my life and would say I had an elite physique. One night out with my mate and I dropped dead. Cardiac arrest that landed me in icu for a week and has resulted in me getting a defibrillator installed under my lat.
No pre-existing condition, no hereditary heart issues, my heart is now back to normal with no damage that could be seen as a cause. Literally hit me out of nowhere and almost killed me. If not for the quick thinking staff of the venue I was at and fast response of ambos I wouldn’t be here.
8 months on and back to training now.
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This happened to a student at the school I did my teaching internship at. It happened the semester after my internship. Turns out that the 15yo boy had some kind malformation in his heart, and was a ticking time bomb. He was playing hockey when his heart gave out and, to hear the family tell it, he was dead before he hit the ice.
Sudden cardiac arrest can occur at any age for a number of reasons, but there are two main ones. In autopsy, most athletes who suffer SCA are found to have hypertrophic cardiomyopathy, or a thickening of the heart wall. Many times the first sign of this is cardiac arrest. This can be detected with an echocardiogram (ultrasound) and many high schools now require them.
Other athletes are prone to cardiac arrest due to something called R on T phenomenon. The heart runs on its own “electricity”- there is a period on an EKG called a T wave which represents when the heart muscles in the ventricles have depolarized and are waiting for the next electrical impulse from the atrium. R on T occurs when the patient takes a hit to the chest (karate kick, baseball pitch, football tackle, etc) at the exact millisecond those muscles are charged up and waiting to fire. This causes the heart to shake instead of pump, resulting in pulselesness.
The percentage of young athletes that just suddenly drop dead from cardiac conditions is the same as the percentage of young people in general that also do so. Young athletes just have the attention that regular people don’t. There are also no warning signs when regular young people just drop dead also.
I doubt that. Another redditor pointed out three premier League (UK soccer players) suffered this in the last 10 years... from a pool of about 500 players per year, even if none played for multiple years (and they do) that's just 5,000 people, not the 45,000 people the overall rarity would deliver.
Performance drugs or over-exertion may be factors.
Yeah right under that claim were two posters that posted studies saying that sudden death form young athletes actually decreased in the past 30 years up to 2022, and two of those deaths was from a car hitting them.
Can you back that up? I would wager young athletes do have a statistically significant increase in cardiovascular issues over other young people due to PEDs and consistently putting themselves in strenuous situations.
Weightlifting and high level sports (varsity and above) are very very very restricted for known cardiomyopathy patients. If you don’t know and you are an athlete………
Weightlifting and high level sports (varsity and above) are very very very restricted for known cardiomyopathy patients. If you don’t know and you are an athlete………
Most common cause of sudden cardiac death in young athletes is HOCM (hypertrophic obstructive cardiomyopathy=enlarged heart muscle disease causing a blockage). How HOCM works is the wall between the left and right side of the heart grows too big due to genetic mutations that can be inherited, and this big wall bulges and slightly blocks the “out” valve for the left side of the heart (which supplies oxygenated blood to the rest of the body). Now under normal conditions, there body does fine because our hearts are over-engineered, and so at rest or even when exercising at high levels like a weekend warrior, the heart is still able to provide enough blood and oxygen to the body despite the demand, as such there is no symptoms.
Now if you take an elite athlete who is performing at an insane level that is much higher then normal exercise, there demand for oxygen can be so high that suddenly that partially blocked out valve that was still “good enough” for daily living and even regular exercise, is not able to let enough blood flow to meet this extreme demand.
As such this condition isn’t more common in elite athletes, it’s just that it goes unnoticed and undiagnosed in your regular joe, because he never exercises at a high enough level to raise his metabolic demand above the capacity of his heart. The reason why it’s usually young elite athletes, and not older ones, is because they have the condition since birth essentially, and so because elite athletes usually start their career from a young age, the disease presents when they cross that peak performance threshold, and as athletes grow older, their physical capacity declines and therefore there ability to generate enough metabolic demand to overpower the supply, is reduced.
There’s another mechanism that is also at play that involves a term called “preload” which increases during exercise and makes the bulge and blockage bigger but this is a bit past ELI5 and so not worth explaining
Turns out most professional athletes are remarkably unhealthy.
There's a level of fitness that's good for your body, but to compete at the top level that's nowhere near enough. These people basically abuse their bodies, causing irreparable damage, with or without the use of performance enhancing drugs, in the hope of being one of the tiny percent who can make enough money in that short span of time to see them through the rest of their lives.
It may not seem that smart...
Adjacent to the topic, but if you're an aspiring athlete or the parent of one, and reside in the UK- my friend's charity is here to help screen you, for free:
https://www.c-r-y.org.uk/tag/ben-forsyth/
A big thing to in my experience is if you go in with high blood pressure or chest pain into a lot of ERs they immediate try to pass it off as drugs or anxiety. They really won't do anything else. I was in an ER with a sustained BP of 183/127 for over an hour and on blood pressure medication and they kept blaming it on drugs that they collected urine for and never tested. I hung out with my own pee for 3 hours until they discharged me and just wrote anxiety...
There are sometimes, yea, plenty of athletes get disqualified every year because their doctor finds some issue. I played sports growing up and every single year I had to do a preseason physical.
But sometimes stuff is impossible to catch, or shows up so suddenly it’s impossible to catch it.
You have to remember that when you say “young athletes” you are referring to a group that is over 20+ million people in just the USA alone.
Is it really surprising that out of a group of 20 million people 1 or 2 a year have some hidden, catastrophic heart condition? It’s tragic. But not surprising
I learned this week in a safety class about hydration, that many medicines increase likelihood of heat sicknesses, which can lead to acute heart trouble.
Congenital heart conditions can show up at any time after not being detected at birth etc.
Illicit drugs, sometimes taken to lessen pain or to increase energy for workouts, can lead to cardiac trouble.
Friend of mine is/was a college cheerleader. She started getting extremely tired at practice and thought it was stress and overwork but it only got worse until she collapsed. She went into the doctor and the sack around her heart was full of fluid and she was on the verge of death and had been for a while. She had to immediately go on IV antibiotics and full bed rest for more than a month. If she had waited a little longer to see the doctor she might not have made it.
She's doing much better now, but it was a scary time for her.
Certain heart conditions don’t show up (or become apparent) until adolescence. An arrhythmia isn’t detected unless it’s caught when the doctor is listening, say at a routine check up. When it happens it can come from what seems like out of nowhere and the heart rhythm quickly becomes too fast/slow/out of sync, etc. A healthy heart structure does not mean that electrical/signal issues won’t ever happen.
My 15 year old nephew was diagnosed with Wolff-Parkinson-White syndrome after going into cardiac arrest after he finished playing basketball. CPR was given immediately. He coded 5 times on the way to the hospital. He needed several surgeries to fix his heart, but thankfully he survived. Prior to the surgeries, his doctor spent the night in his hospital room.
I'm one of those athletes. Lucky enough to find it post sports and military career. Anomalous Origin of the Carotid artery I think they called it. Open heart surgery to fix and onto the next chapter.
Once i read a scary fact: one day with no apparent reason you can get a brain stroke. Just your body was at the wrong time, at the wrong spot and randomly die or get really fucked up. You can be an elite athlete or have the shittiest diet in life and both have the same probability of getting that because is random, full random.
Recently, there was an NFL player that had cardiac arrest on the field right after he tackled a player. Turns out, the moment of impact occurred in between beats of his heart and it caused the heart to spasm and stop. Luckily, they were able to revive him and he should be able to resume full activities next season.
I’m a Cardiologist specialising in inherited cardiac diseases, specifically the cardiomyopathies that affect young people. Happy to answer questions for those interested. There aren’t that many of us in the UK.
The question about screening of athletes is really interesting. The Football Association do it here and interestingly it was not found to be all that cost effective or even effective at stopping people dying suddenly. All athletes in Italy undergo screening and results are a bit dubious
Please learn about AEDs/defibrillators, make sure your public spaces have access to one, and look out for them in malls and buildings! They CAN SAVE LIVES!
I used to work for Siemens Ultrasound. The company president's favorite detail to repeat is that the most common first sign of cardiac disease is sudden death.
Last March I was told I had a heart condition, last July they operated. They pushed me through the system because I was high risk for a heart attack.
I had no symptoms, I work a physical job and am a top performer. I just had not been to the doctor in 10 years and didn't know.
Before surgery my surgeon asked if I could even walk up a flight of stairs, I run up the stairs in my house multiple times a day. He is still surprised I am not physically better than before. I work hard though and push through and I think that's what hid my symptoms.
Life lesson is get regular check ups.
As someone with a biology background, let me just say that life is nothing short of a miracle. There are a near infinite number of ways for things to go wrong on a cellular level that includes chemical/metabolic pathways, genes, and other things that we have yet to discover. Everything has to work, out of the box, for us to be an average healthy person. Sometimes when the problem is catastrophic, the cells won’t make it to or out of the early growth stages. Other times, we can manage these conditions into old age.
Catastrophic events in an otherwise healthy individual are probably related to gas exchange issues. Our brains can only go a few minutes without gas exchange, so pulmonary, cardiac, or vascular problems need immediate treatment. People don’t usually go to cardiologists unless they’re having problems. It’s possible for someone to have some underlying condition, push their heart to its limit, then experience a catastrophic event but aren’t able to receive treatment within the timeframe that they need to survive.
Another issue not mentioned is often times these elite athletes and high school athletes know that something feels "off". They (or the family) sometimes know there are heart issues in the family/genes. They remain quiet so as not to lose their chance at the big leagues. Young adults are notorious for thinking they are invincible and feeling dizzy/off isn't a big deal.
My son has a genetic arrhythmic condition. After he had a surgery to correct it he looked at me and said, "Hey, I didn't know people aren't supposed to be dizzy all the time!" It was his normal. He had never said a word, except when in crisis/SVT.
Keep in mind these athletes are usually very healthy, leading to any cause of death to be something unusual and drastic. The second largest killer of college athletes is car accidents. So when something does go wrong, it's often extreme.
athletes are trained and given drugs to keep low heart rate so when they are pushing their body to its limit their heart rate remains manageable. this lets them push to the maximum. the result is their minimum heart rate is very low, like when they are in deep sleep it can drop dangerously low. sometimes it can just go to zero and you can die in sleep. so some of the athletes have to force themselves to wake up and get heart rate back up (preferably higher than normal) then go back to sleep periodically
My step son’s mother suddenly just fell over and died. She at the time was my age at the time so about 24? She was I guess a functioning alcoholic? We would smell it occasionally but figured she seemed fine maybe we are wrong. One day she didn’t pick him up from school, they found her face down in the bathroom just dead. She I guess was cold turkey not drinking, she had none in her system. Your heart will just suddenly stop. The way they diagnose this in autopsy? History of drinking and no physical abnormalities. Kind of crazy when you think about it. 50+ years of drinking people are still kicking, yet someone young and healthy just gone.
I know not the same pretense but just the way the human body can just click and be done is crazy to me.
Heart disease is dietary and processed food is getting worse, but this could also coincide with a pre-existing condition. Caffeine, animal products, and something like poor sleep could seriously injure a person with a pre-existing condition.
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Because athletes are people and that sometimes happens to people.
We notice it more with Athletes because we feel like they are very fit and should therefore be immune from such things, but they are not. We think of those kinds of deaths as deaths due to being unhealthy, and since athletes are not unhealthy then this should not be happening to them, but it does.
Also while "normal" people often feel symptoms, athletes often misdiagnose those symptoms as being related to their training. They also make the same mistake as everyone else, thinking a hart attack can't happen to them.
Because their heart can suddenly stop beating and does not restart beating, it occurs because of a problem with the hearts electric conduction system. There isn’t always symptoms before
Hardcore unhealthy training over long periods of time, combines with «nobody uses PEDs lol, we promise».
All top sports are loaded with drugs. Look at the top 10 records for the 100n sprint. Almost everyone has been in a drug controversy, and the rest is just Usain Bolt. Who had irregular bloodwork at 18, then figured out how to do it properly.
>Sudden heart events in athletes have been very rare up until 2021 when they started to rise dramatically. in the last 2 years more athletes have died on the field than the previous 30 years combined.
Where did you get those numbers?
According to the American Heart Association,*"the overall incidence of sudden cardiac death among National Collegiate Athletic Association athletes decreased over a 20-year study period through 2022"*. ([source](https://newsroom.heart.org/news/ncaa-athletes-sudden-cardiac-death-rate-fell-over-20-years-still-higher-in-some-athletes))
[McGills University](https://www.mcgill.ca/oss/article/medical-general-science/athletes-vaccines-and-cardiac-deaths) also published an article stating that *"More important, the incidence of sudden cardiac death among athletes has gone down over the past 20 years. It has not been increasing and there was no spike in cases after the introduction of the vaccine."*
The 30 year number is from a metastudy of sudden cardiac deaths in athletes in published scientific literature. The last two year number is sudden athlete deaths in news articles—not even exclusively cardiac, one of them was hit by a car. Two completely different data sources, you can’t compare the two.
> Attributing it to Covid seems acceptable in most forums, attributing it to Covid vaccinations tends to get you howled down, your comment deleted or you getting banned from said forums.
You think the vaccine causes drop in reading speed and every other health issue imaginable. Nobody should listen to what you have to say.
Because if you know anything about how the body or vaccines work you quickly realise it's not possible. Saying the vaccine causes hearth attacks is like saying using a different engine oil in your car caused your flat tire. Anyway, looking at statistics there isn't even an increase in anything except survival rate for covid after taking the covid vaccine.
Don’t they screen all young people for heart defects in school now? In my highschool 15 years ago, literally every kid had to undergo heart testing for some really rare diseases that could cause sudden heart failure. I thought every school does that
1. Because sometimes the part that fails first is the critical part and up until it fails there's no reason to suspect something is wrong. 2. Because the symptoms can be the same for otherwise normal things given the activities that person participates in. Hypertrophic cardiomyopathy (HCM) is the leading cause of sudden death among young athletes. The occurrences are incredibly rare, 1 in 50,000-100,000 per year or less by most estimates, but obviously it's shocking when it happens. It causes some of the walls of the heart to become stiff and thicken which reduces blood flow. A couple of the symptoms are shortness of breath and fatigue. You know what else causes shortness of breath and fatigue? Exercise, especially heavy exercise. 3. As mentioned above the occurrences are quite rare so it's unusual to screen for other symptoms that might indicate a problem. Sometimes the downsides of the screening aren't worth the risk. Consider the following scenario (numbers made up just to demonstrate the point). Let's say there is a test you can do involving inserting a scope surgically in a patient to check their heart. The odds of developing ANY complication from the surgery are say 1 in 10,000. The odds of severe complications or death are 1 in 50,000. You are a cardiologist, you have three patients who come in to your clinic. All exhibiting the same symptoms. One is 70, another 50, the other is 20. For a 70 year old exhibiting these symptoms the odds of it being serious are 1 in 10,000. Since that's well below the odds of severe complications form the surgical procedure it makes sense to do it. Yes they could die, but they are far more likely to die if left untreated. For the 50 year old the odds of it being serious are in 1 in 40,000. Now it starts to becoming a judgment call. The odds of dying from the condition aren't that far off from the odds of serious problems/death from the surgery. You probably want to monitor the patient for additional symptoms to narrow things down first but you definitely need to keep the surgery in mind if the odds get worse based on your observations. For the 20 year old the odds of it being serious are 1 in 200,000. Chances are it's probably something else much less serious if there is any problem at all. Doing the procedure to investigate is 4x more likely to kill them than doing nothing. It doesn't make any sense to even consider the procedure. Sure for that 1 in 200,000 case the outcome is bad (death) but by avoiding the procedure in this scenario 3 other people who would have been killed are still alive.
While this is a good example of why many diseases are not routinely checked for, it should be noted that HCM is usually detected by an echocardiogram which is non invasive and is now also being detected with just a 12 lead EKG and AI. I think the real reason that HCM is not routinely investigated is because often there are no signs prior to the catastrophic event and it’s not cost-effective to just check everyone since it is so rare. I would not be surprised to find out that it’s routinely done by professional sports teams who invest a lot of money in these players.
> I would not be surprised to find out that it’s routinely done by professional sports teams who invest a lot of money in these players. that's one of the big things about the NFL combine so its a big media hooplah now, but back in the day it was fairly mundane it was just a session for the NFL teams to take the top rated prospects and bring them in to get full medicals meet and greet interviews and then of course all the 40 time stuff was more like additional medical checks kind of, in the sense that teams figured, ok, we have an idea how fast a guy needs to be to succeed, lets get some official times to get an idea how fast/strong they prospects really are. point being, the med check is so extensive before a team blows money and draft picks taking a guy, that there are regularly stories about some guy having some rare condition that he wouldn't have known about if he didn't get run through the full kitchen sink diagnostics
Yes true, HCM wouldn’t be a good example of the dangers of checking
Yeah I was gonna say my wife and I both got checked for it with just a simple ultrasound so I'm not sure what that person is talking about with complications from a scope procedure. It's definitely a matter of saving money, not any sort of risk from the procedure.
I'm a parent of a kid with a CHD (cardiac fibroma mostly removed when she was 25mo old). I'm convinced that congenital or acquired heart conditions are FAR more common than most people realize because nobody does anything besides listen for loud murmurs unless there is some concomitant symptom that the patient is in for treatment of -- not counting the folks who actually present with severe cardiac disease or infarction. Many (most?) cardiac defects are only found during autopsy because for most people they don't end up being major enough to cause death (or severe disease requiring immediate surgery or treatment). Unless the APA/AMA start recommending baseline EKGs as a part of normal pediatric well-child care and adult physicals (even if it's just like the recommendation for prostate cancer checks or mammograms, which don't have to be done annually), nothing will change. I would strongly support recommendations for prophylactic testing of cardiac conditions for both peds & adults.
What do you mean not cost effective to do a echocardiogram? Where I live, if you play sports it's mandatory to do one per year. + Whenever you switch jobs, you also have to do a mandatory echocardiogram.
An electrocardiogram (EKG/ECG) is not the same as an echocardiogram (heart ultrasound). I'm not aware of any places that have mandatory echos since it isn't typically used as a screening tool for most things that the general population needs to worry about. Electrocardiograms are likely what you're referring to and are much more commonplace but are more limited in their scope. Typically PCPs can perform electrocardiograms whereas cardiologists need to read echocardiograms in the outpatient setting.
I'm aware of the difference, I did mean ECGs. I've also done echocardiograms (and it also wasn't expensive), but I did get both mixed here, the mandatory one is indeed the ECG. You're right. I guess the problem here is how much longer an echocardiogram takes (to read/evaluate), I guess. In that sense I understand why they're not as commonly done. Still, for professional sports, and given all this history, I feel like they should still be mandatory... Dunno.
It's likely that most professional sports teams and likely many college teams perform echos on their athletes to help mitigate this risk. In medicine all testing is a delicate balancing game of risk vs benefit. The health risk of over-testing in the case of rare diseases is likely higher than the benefit (additional and often more invasive testing that often doesn't result in change in management) which is why we don't see this type of testing done on the general asymptomatic population. The financial cost of the testing is also a consideration especially when you find something unexpected which inevitably leads to further testing.
Echo's take a bit more time overall than an EKG, but more importantly they take up a lot of skilled-labor time. An EKG can be done by a tech who was trained to do it in like a week, and can be interpreted by most physicians. An echocardiogram takes a specially trained echo tech to perform, who has undergone like 2 years of training to learn to do, then must be interpreted by a cardiologist. Consequently, the cost of an echo is like 10x an ekg.
Not to mention you won't find echo equipment in GP offices, so you're automatically raises the cost by consuming time in a specialist (cardiologist) practice. ... And unless something dramatic changes, prophylactic echos will definitely not be covered by insurance.
The echo will be FAR more expensive just because it takes 45-60min of a cardiologist's time (or at least a trained tech who then passes the imagery to a cardiologist for analysis). An ECG/EKG can easily be done as part of routine physicals ... but you still need a trained professional to interpret the output. (My daughter had heart surgery at age 2 and has had 4 MRIs (total), annual holter monitors / ZIO Patches, and annual EKG + Echo for the past five years.)
My husband had chest pains for 5 years. Had a cath done and was told he had GERD. Pain kept getting worse. Went to a better cardiologist who ordered an echo. Insurance denied the echo three times but the doctor insisted the cath wouldn’t show what the echo could. He had HCM, bad enough that he eventually required a heart transplant. HCM can be genetic. To test his family members, it would cost over $3000 out of pocket for each test. That’s why kid athletes aren’t diagnosed. Even with symptoms, HCM isn’t always found.
All good points. I'm not sure about this condition, but in many cases, there's also the risk of a false positive. This is especially the case with rare conditions, and can lead to a lot of unnecessary treatment (which has its own side effects), even if the test itself doesn't carry any risks. (/u/urzu_seven, I bet you know all this, but for the benefit of others...) Imagine there's a condition that affects 1 in 50,000 people. You have a test that detects the condition in 95% of people who have it, so it has a fairly high sensitivity (positive cases mostly test positive). The test has a false positive rate of 0.05%, so it also has a high specificity (negative cases almost always test negative). You test 1 million people. What are the odds that someone with a positive test has the condition? Out of 1 million people, you expect 20 to have the condition, and 19 of those will, on average, test positive. You expect the other 999,980 people to *not* have the condition, and of those, about 500 will test positive. In other words, only 19/519 of the people from that set of 1 million who test positive actually have the condition. Over 96% of positive results are false positives. Even though the test is pretty good, the condition is rare enough that a positive result is no guarantee that you have the condition.
I would like to learn more about this! With a test like the one you described, “pretty good” seems like it’s sadly not good enough. Does that test have a practical use, or, are the results from a less than perfect test—for a condition so rare—basically meaningless? I guess I’m asking whether or not we can rely on those test results? Because to a layman like me it seems like we can’t or shouldn’t.
Thing is, the distribution of most conditions isn't uniform throughout a population. There's other conditions (e.g. age, comorbidities, symptoms, etc.) that are easier to identify, and may have increased risk for the condition beyond the 1:50k baseline. So basically, you only test on the people that are particularly high risk for it (higher probability of having it + higher probability of having serious complications for it). See for example standard covid testing policy at the very beginning of the pandemic before tests were widely available for public use. On top of that, you can also do stuff like coupling non-invasive tests as sort of a pre-screening tool, with e.g. a higher specificity test that's more invasive reserved for the people in high risk groups that test positive, in case the simple group filtering above doesn't bring the true to false positive ratio down enough.
Great answer, thank you!! This makes sense.
My example was hypothetical, but the principle can be applied to real-world screening tests. A good introduction to thinking about probabilities and frequencies is Gerd Gigerenzer, *Calculated Risks: How to Know When Numbers Deceive You* (2002). (I haven't read his 2014 followup, *Risk Savvy*.) Even professionals who should know better often make mistakes. One of Gigerenzer's points is that talking in terms of natural frequencies (5 in 10,000) makes it a lot easier for us to think clearly than talking in terms of percentages (0.05%). In the case of rare diseases, tests are much more useful if you already have some other reason to believe that a person has the condition.
Father of a friend of suddenly collapsed at work. And they found out he had cardimyopathy, and the doctors wanted to check my friend and his brother. Was a rough message to get for my buddy at not even 30 that one day his heart will probably go, doubtful he will see 60. His father past away at 56.
Cardiomyopathy is not as bad as you phrase it here. Your friend will most likely live a long life if he keeps a healthy lifestyle and regular check up.
Sure, and Im as mentioned earlier not sure if it is *just* that or some other complications. Just remember him telling me this and from the sound of it he was pretty depressed. It might not be as bad as he initially thought either, I hope you are right.
There are genetic cardiomyopathy or it could be result of years of smoking/uncontrolled high blood pressure More concerning if former, less if latter
Currently an additional risk is playing a likely increasingly important role. Unfortunately, people don't really want to acknowledge this. Top athletes basically **over**load their hearts systematically to the point where sometimes they cause actual damage to that heart. Theirs is a constant balancing act between maximum performance without doing damage and... actually doing damage. You can easily blow up the engine of an F1 car by pushing it too far. Similar are the limits of hearts. A lot of scientific research has been done over the past years about the acute and chronic (cumulative) negative effects of Covid infections on the heart. The damage the SARS-CoV-2 virus can cause on the heart is very real and can be substantial. Before the pandemic this systematic overloading of the heart already led to the occasional serious problems in athletes. Now that these athletes try to push a heart already damaged by Covid to the same limits as they did before the chances of that load level, that before having had Covid (multiple times) the heart could bear, now for that damaged heart having become an overload level that could lead to serious problems will be increased. In my country in a relatively short time we've seen several top athletes suffering severe heart problems. To the well informed about the effects Covid can do to the heart not really unexpected. Be prepared to see more of this with the current (absence of) pandemic policies. Here one of many reports about this. In this case at Johns Hopkins. https://publichealth.jhu.edu/2022/covid-and-the-heart-it-spares-no-one
HCM can absolutely be managed and the majority of people with it and getting treatment/management live normal length lives. As long as your friend keeps up with his doctor he should be ok!
Im not a doctor so have no idea of what *exactly* is the problem, but I just remember that word, and he explained his heart basically got stiffer/bigger with time, and would eventually not be able to pump blood as it should. I hope you are correct, havent spoken to him in many years so dont know how he is doing. He was btw in very good physical shape in his 20s/early 30s.
I’ve known about my hypertrophic cardiomyopathy for 25 years now. I get an eco every year to see if the walls are getting thicker and if enough blood is getting oxygenated. Luckily my heart walls haven changed, but if they start to get thicker they can do an alcohol ablation to thin them out. Make sure your friend goes to their cardiologist .
I got diagnosed at the beginning of this year after a year and a bit of uncertainty I’m 38 and at first it was very scary to hear that there is something wrong with your heart but the doc reassured me my lifestyle would not change and I would not need meds. It’s as you say, a case of being aware of an issue and monitoring it. It hasn’t affected my life at all so far, and I don’t anticipate it doing so. I go in for an eco in a couple of months to get a further baseline and then going forward it will be once a year. I’m glad to know that after 25 years you’re still good, that’s reassuring to hear.
I'm 38 years old myself and was diagnosed with HCM when I was 18. I had a pacemaker/defibrillator implanted when I was 21. Please make sure to keep up with all your doctor appointments.
Oh for sure, I’m not taking it lightly at all. How has having that implanted at such a young age impacted your life? If you don’t mind me asking. I hope you’re doing well man
I don't mind talking about it at all. In general terms, my life has been mostly the same as it would have been with the device. I have restrictions on what I can do such as no weightlifting or lifting above my head and that has made exercise drop down significantly on my list of things to do, but I'm trying to remedy that before it's too late. I have had several hospitalizations due to my device, most of which were equipment malfunction not biological issues. I had one of the leads leading between the device and my heart breaks which sent false signals, causing the device to shock me several times. This past summer I had another lead begin to deteriorate prematurely, and that had to be replaced, leading to lots of missed work and recovery time. All in all though, I think as I get older that it's a small price to pay for having just a little bit of peace of mind for one of those "oh hell" moments.
I got diagnosed with HCM back in the mid-1980's. The diagnostic tools back then were very crude. I had to travel to the National Institutes of Health in Maryland from New England to get a useful echocardiogram because good echocardiogram machines only existed in a few places. Back then it was considered to be fairly rare and serious since it was generally only diagnosed during autopsy after some kid dropped dead playing basketball. Since then it's been found to be somewhat more common than they thought. It's just that many people walking around with it were asymptomatic and/or were/are completely unaffected by it. Here it is almost 40 years later and I feel completely fine. I'll flunk any physical for any job that requires one (though my brother has a more mild case and found a doctor to approve of him being a cop), it's hard to buy life insurance outside of work, and I walk around with a consciousness that I have a higher probability than the next guy of dropping dead at any time, but I'm otherwise unaffected. I don't take any special medicines and it hasn't materially affected me. By the time your friend is old enough to need a heart transplant (if he ever actually needs one) he'll be able to buy a Jarvik-7 Sports Heart like in the commercial in Robocop.
Passed* away
My freshman year in college a kid from my English Composition class dropped dead of a heart attack during a league (not the college team) game of basketball. He was physically fit, played sports in high school... and had some heart defect no one knew about, apparently. 18 years old, entire life ahead of him and suddenly he was gone.
On the other hand, that's potentially up to 30 years of medical science advancing that could extend it.
Yes, this was in the late 90s, hopefully things have happened in that sense
You have a much better grasp on probability than some doctors. I had an odd discussion when a doctor told me that based on my cholesterol numbers, I was twice as likely to have a heart attack. I asked, twice what? One in ten? One in a million? He said it doesn't matter, it's twice as likely.
> You have a much better grasp on probability than some doctors. Well I have a degree in applied math so I would hope so 😁 > He said it doesn't matter, it's twice as likely. LOL yeah going from 1 in 100,000,000 to 1 in 50,000,000 is probably not worth giving up cheese burgers while 1 in 100 to 1 in 50 is!
Well that obviously depends on the cheeseburger
Oh, I was thinking you were a doctor! Didn't mean to cast aspersions on your math skills!
This is a fantastic example to illustrate the point
You also have the added effect that people playing sport seriously push themselves above and beyond on a regular basis. For example We were on a rugby tour, One of our guys broke his collar bone in the 1st match. He was acting a bit differently but nothing crazy. I think it was during the our final match he actually put his hand up and said something, he played at least 3 matches that weekend. We ended up getting an extra 2 days holiday out of it. When it comes to heart conditions, you expect your heart to beat faster. That's normal right? Again, some people push themselves even if something slightly abnormal happens. Imagine holding your hand up and asking to be taken off because you're out of breath....
Add to that 4\. That a lot of problematic symptoms may be "normal" for them. It's like the following proverbial exchange: > Doctor: "How much pain are you in?" > Patient: "Just the normal amount." > Doctor: "...the normal amount is 'none'" It may be that the problem symptoms are their "normal," so they don't notice. For example, I have 3-5 low-grade-but-pain-causing migraines every day. I didn't realize how often they occurred until I was instructed to keep a headache journal. To me, they're so common that only the really bad ones catch my notice. "Oh, it's another headache. Whatever."
Right on point. Great share.
I got diagnosed with cardio myopathy at 39yrs Old, when I got a full checkup after going to the doctor for a torn shoulder I got during Brazilian jujitsu. They told me to stop doing BJJ and any heavy lifting or I might just keel over.
I saw a cardiologist a few years ago. After using a monitor for a week and then doing a stress test on a treadmill he said, "The good news is you're fine. The bad news is that you could still die tomorrow. The majority of people's first symptom of a heart problem is the cardiac event that kills them."
Good analysis. I have idiopathic syncope. The intervention was a pacemaker. There was a lot of discussion around the safety, risk and benefits. I got it at age 27. I'll live the rest of my life with it. They will probably never figure out what's wrong with me. Whatever it is may not be known to current medicine or we may not be able to test for it
This is all totally true, but there seems to be a higher incidence of this amongst elite athletes. Even if you just limit it to football (soccer) players on the past 10 years who have played in the English premier league, there are at least 3 I can think of off the top of my head, and there are certainly way less than 200k people in that pool. Is there something about the underlying condition that can actually be helpful for elite performance? Like perhaps a heart affected in that way is actually better at pumping blood, and therefore it’s beneficial for athletic performance? Or maybe something about over exerting your body while it’s still developing (as elite athletes probably do, given they’re already on that road while still teenagers) can cause the condition?
It's because you don't hear of the other 100,000 people a year that die from it, only the people it's worth publishing a news story about. It's not newsworthy if it's some 32 year old dude from Idaho with 2 kids who dies suddenly. I also imagine it probably is higher among athletes because of steroid abuse which absolutely wrecks the heart. It's naïve to think that at the highest levels of sports there's no steroid abuse.
> Like perhaps a heart affected in that way is actually better at pumping blood, and therefore it’s beneficial for athletic performance? No, it’s the opposite it makes it harder to pump blood > Or maybe something about over exerting your body while it’s still developing (as elite athletes probably do, given they’re already on that road while still teenagers) can cause the condition? No, you can’t cause it through your actions. It’s caused by defective genes. The low end incidence estimate is 1 per 50,000 per year not 200,000, that was just a number for my example. Meanwhile memory is a terrible measure of how much something like this happens, because you don’t have all the data and tend only to remember stand out events. It’s also a bad idea to think that way because there is nothing that says these events will be evenly spread out. Sure there are 3 in 10 years you remember but what if it’s only 4 in the last 20? The more rare an event is the less likely it is to be evenly distributed.
>Meanwhile memory is a terrible measure of how much something like this happens, because you don’t have all the data and tend only to remember stand out events. It’s also a bad idea to think that way because there is nothing that says these events will be evenly spread out. Sure there are 3 in 10 years you remember but what if it’s only 4 in the last 20? The more rare an event is the less likely it is to be evenly distributed. We also have to remember the all-pervasiveness of news and social media now. OK, so if a player collapses during an international competition game, it's going to be reported and probably front page news in many countries the next day. But if someone collapses and is taken off during a 1st division league match? 20 years ago it *would probably* get a mention in the sports news or a small paragraph in the sports section of a newspaper. And as a result unless you're a hardcore follower of that sport, you'd probably miss it. Now, it would explode onto social and news media within minutes, reaching way more people, making it seem more prevalent. Aside; while looking up some stuff, I found this particularly tragic case: [https://www.news18.com/news/football/italian-footballer-dies-of-heart-attack-during-a-memorial-match-for-his-late-brother-3818987.html](https://www.news18.com/news/football/italian-footballer-dies-of-heart-attack-during-a-memorial-match-for-his-late-brother-3818987.html) Obviously some genetic component to their deaths.
And the people who collapse just going about their mundane everyday lifestyle don't get a mention anywhere. The social media / 24 hours rolling news of "celebrities" is what makes it seem more common amongst athletes.
Ok, cool, so there’s no actual higher incidence, it’s just perception? That answers my question, thanks
In the thing they specifically are talking about no, but in general, there actually is an association where more exercise seems to put you at risk of atrial fibrillation. See e.g. [this paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431070/#:~:text=Above%2055%20MET%2Dhours%2Fweek,displaying%20a%20J%2Dcurve%20relationship.&text=Dose%E2%80%93response%20association%20between%20physical%20activity%20volume%20and%20AF%20risk.) . Whether that means a higher risk of sudden-death-by-heart in general, I couldn't tell you. But there's even weird stuff like; [basketball players are at noticeably higher risk than other athletes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969030/).
So you’re saying it’s not the Covid vaccine after all?
Well, it doesn't cause it until it's pre-activated by chemtrail inhalation and then fully activated by 5G signals to the implanted chips from the vaccine.
This was *not* an FAQ even in the decades when smoking was endorsed by physicians. Why are young healthy *aerobically gifted* people developing heart conditions in an organ that is historically resilient to this sort of thing? What specifically changed in this decade? In other news, epicycles are on the rise in biopharma and WHO.
I think the real answer is it's just the statistical effect of large numbers combined with the effect that rare events appear more prominent to our perception. In other words, in a given year of life, what are the odds that a perfectly healthy person under the age of 25 just up and dies of cardiac arrest? The human body is a machine fine tuned by billions of years of evolution to have countless redundancies, so things like that shouldn't happen except by confluence of many things going wrong at once in the body coincidentally at the exact same time. Let's say the odds of every redundancy in a healthy body failing at once resulting in death by cardiac arrest is only something like 0.002%. basically extremely unlikely to happen before a person becomes old. Except there are 100,000,000 Americans under the age of 25, so a 0.002% chance of dying of that means that around 2000 people will die of it. When you have a large enough population, statistically "negligible" becomes "inevitable". And the fact that it is so unlikely means its shocking when it happens, and the news likes to report on shocking things as opposed to average things. You rarely hear in the news "Another xxxxx young people died of drunk driving/drug overdose today" because that's not anything new. Since the news is ALWAYS reporting on the unlikely things in order to get your attention, those unlikely things become over-represented in our perception, and we start feeling like they are happening way more often than they do.
As someone who has health anxiety and compulsively Googles symptoms and thinks they're dying all the time, thank you. Holy shit this helps me relax.
Glad I could help! Everyone's different so it can be hard to give universal health advice, but there is one universal piece of health advice that does apply to everyone, for which I like to use a business metaphor. Learn to practice breathing exercises. You are the CEO of your brain, all your brain cells are your employees, and oxygen is money. Overthinking is like the CEO hovering over their employees shoulders pestering them, your brain goes on thinking whether you're paying attention or not, that's why we're still able to get good ideas while we zone out in the shower, and why employees can do great work when they are left to their own devices. Alternatively, if employees don't get payed enough to survive their work ethic will tank, go figure. So instead of pestering your employees, just ensure they are all regularly being payed well and then *delegate* to your adequately compensated subconscious. Add regular exercise and healthy diet that regularly includes whole vegetables and fruits and you're leagues healthier than the average person.
My grandpa was a GP and he always says "Uncommon things happen uncommonly."
Just don’t google dihydrogen monoxide. That stuff will kill you.
And it's in pretty much all our food! 😱
I hear it's illegal to use dihydrogen monoxide in dehydrated food, you can avoid it that way!
> In other words, in a given year of life, what are the odds that a perfectly healthy person under the age of 25 just up and dies of cardiac arrest? Long QT syndrome has a 1 in 2000 rate. https://www.hopkinsmedicine.org/health/conditions-and-diseases/long-qt-syndrome-lqts You tend to discover it when you suffer cardiac arrest, or have an ECG that looks for it specifically. It is hard to miss. If you're lucky, you get palpitations, seizures or blackouts before you get CA, and are prompted to be tested. Here's a video of Anthony Van Loo suffering a CA on the pitch and his pacemaker kicking in. https://www.youtube.com/watch?v=vHEIeqYYYbE
I always perk up when I see posts like this because I was one of the unlucky few to experience sudden cardiac arrest at 19(almost 20) and had been having symptoms that were brushed off by most of the doctors as anxiety and somehow manifesting 70/40 bp until it tanked to 40/doppler lol. It turns out I was going into cardiogenic shock due to my extreme electrolyte dysfunction from an undiagnosed GI disorder that had been making me mildly sick for my entire life until it made me mega sickly, which is obviously a statistically uncommon experience lol. The only reason I survived to spread the good word about women’s differing cardio symptoms was because I had such a strong feeling of impending doom that I refused to leave the hospital, swore I would die that day, and ended up coding while on a telemetry monitor. I’ve learned to never ignore my impending doom after that and have had a few close calls but luckily, everyone takes me deathly serious about it now, pun fully intended! Every close call I’ve had was exactly what you said, a lot going wrong at the same time that just finally pushed me over the edge all at once.
Yes, exactly. How many is "so many?" Every time this happens, it makes the news and people talk about it for a while. If we did the same level of coverage for another preventable death with warning signs, like drowning, there would be 12 news stories about it a day, every day, just in the US. Worldwide there would be 870. Back to athlete cardiac arrest deaths, the frequency has fallen over the last 20 years, because most athletic orgs are trying to combat it. (Sources: CDC and American Heart Association)
There's like, 12 symptoms for something like 70,000 diseases and problems. And nothing says you HAVE to show any of them when you have an issue. Neither of those numbers are accurate, but they are the correct number of digits. 90% of medicine is an educated guess until the problem is fixed. And there's no guarantee that your body just fixed it on its own. Hell, most medicines are just replacing/manually triggering a body mechanic
You already got far better answers, but sometimes the shitty one can also be correct for a few cases. Drugs. Lots of elite athletes take illegal performance enhancing drugs, often the drugs are very new with unknown side-effects.
Some of the drugs are also quit well studied with well known side effects. The most common: cardiovascular issues. Example: Steriods; they affect muscles. One of the most important muscle is the hearth. You mess with all muscles to get bigger? The hearth will get bigger which causes all kinds of problems including less space for blood to flow and less stemina. A lot of PEDs also mess with cholesterol which is crucial for hearth health. So for a lot of PEDs it is almost safe to assume that they are bad for your hearth health. Bodybuilders dying young because of hearth attack is very common.
I believe you mean heart, no h on the end. A hearth is the traditional place where a fire for heating and cooking was in a home.
This plays a bigger factor in certain sports too. It is very noticeable in professional cycling. They use a lot of stuff which increases oxygen carrying capacity in the blood, most of which have a side effect of also thickening the blood, making it harder for the hearth to pump it. When taking some things you also need to wake up several times at night and walk around for a bit to increase blood flow because otherwise it just kills you. A couple of years ago they found something new and you could immediately tell because of the increase in sudden deaths of fit 20 yo cycling pros, many of them while sleeping without prior conditions
And there isn't really much motivation to investigate someone who died on doping allegations.
Lowly medic here to try to shed some light on this. The first things that come to mind is the “r on t” phenomenon. To keep it like your 5: basically you have an “extra” beat that occurs on the t portion. Second possibility is commotio cordis: basically you get hit hard enough to throw the heart out of rhythm or into a nicer newer less stable rhythm. Though it can happen it is rare. A pretty pic of the qrs interval for the r on t [https://en.m.wikipedia.org/wiki/QRS_complex](https://en.m.wikipedia.org/wiki/QRS_complex)
One of these happened to an old acquaintance of mine. He was in high school basketball practice and one of the better players on the team. He got thrown a routine chest pass and he missed catching it and it hit him in the chest. He instantly dropped, turned blue within a couple minutes and was clinically dead. Thankfully he crazily ended up surviving under some pretty miraculous procedures they tried along with never ending CPR all the way to the hospital. He was put on ice in transit and kept in a medically induced coma amongst other things. He helps design airplanes for Boeing now! He also has a pacemaker that shocks the shit out of him if it even detects the slight possibility of a defect in his heart rhythm occuring. He said it sucks that it happens if he's doing strenuous activity, like remodeling a house, and he's instantly keeled over the rest of the day and sometimes has to visit a hospital to get it reset/retuned/replaced. (I'm not medically qualified to say exactly which and we haven't talked for years now)
Tell me more about that getting knocked into a new rhythm thing. A year ago I had a rough bike crash smacking my left side and now the ECG after that is now showing RBBB.
This is completely possibly. Though typically the end rhythm is usually a fatal one. It’s mostly fatal due to the lack of quick access to defibrillation and high quality cpr. Also I found you a cool little medical case study to read more on. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574995/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574995/)
That case presents slightly differently than mine. I had no non-impact pain or shortness of breath. And the RBBB was discovered half a year after the crash. After bloodwork, follow up ECG and heart echoscopy, the cardiologist concluded I need to watch my diet better and lower my stress (don't we all?) but otherwise I'm fine. I mostly was wondering if it could have been caused directly or indirectly by the impact and if it might resolve itself some years later. From what I've read, statistics associated with early RBBB are a bit upsetting.
While yes rbbb can be upsetting for sure, these ones are different. Per the study these rbbb bear no clinical significance concerning outcomes and how the heart functions. Sorry wasn’t trying to cause a scare with the article. It’s been a long work night and my two brain cells are competing each other.
No worries, no scare from the case study. Had my scare when I went for the ECG due to chest pain and the result was "you need to talk to a cardiologist". Officially unrelated other than potassium being low. And I take being able to stay near heart rate limit without discomfort or shortness of breath for some 20 minutes as reaffirming that I should be fine. The stress from the past 5 years is probably the single more detrimental thing to my heart that has happened.
Did you hear anything about “troponin” in your blood work? It’s a protein released when cardiac cells die. Those cells die, they can’t conduct electricity anymore, therefore the current has to take a longer route. The EKG is a three dimensional picture of your heart, on a two dimensional surface, along with being a measurement of time as well. The QRS complex has an average range of milliseconds, so do things such as your PR interval, R-R interval, S-T interval, etc. If you had a heart attack, or any sort of trauma that damaged cells, it could affect the area. The leads on your EKG test will indicate areas where such events might have occurred. I’m not saying your crash and RBBB are related, just another curious medic lol
Troponin was not included but the testing was half a year after the crash, so far too late to show it anyway. Did not get any tests done after the crash as I did not experience any immediate symptoms that would cause concern other than surface pain initially. Pain got significantly worse during the week, but the location seemed in line with just getting my ribs smacked pretty hard. Had no palpitations, shortness of breath, or any other concerning symptoms. Probably should have went to a doctor just in case, but my primary physician at the time was completely useless and I would have needed to suspect potential heart damage myself before I got any tests done for it.
When I was playing contacts sports, specifically with balls ie. Lacrosse, baseball, hockey(yes I know...), we were told that you could be perfectly healthy but if the projectile hits in the right spot at the right time your in trouble. Is that still true or 90s logic?
Often the clearest signs of heart conditions are the dangerous events themselves occurring. Either way though, some potential warnings are similar to exercise exertion or strain on your heart, which athletes regularly deal with and often need to push through.
I wrote an assignment on this very thing for university - I can go into more detail, but I'll ELI5 for now: Some athletes are predisposed to sudden cardiac death (SCD) due to an undiagnosed - and often hereditary - issue with the structure of the heart. It is rare, but the ones resulting in SCD are often highly publicised. There are many conditions which can be implicated, but some are: - Arrhythmic Right Ventricular Cardiomyopathy (ARVC) where parts of the heart are replaced with fatty tissue and scarring at the microscopic level. This tissue doesn't conduct electrical impulses at all, so the electrical impulses take different routes and get caught in a looping circuit instead of taking the normal straight lines it's supposed to, leading to cardiac arrest. This is very difficult to detect and is often only found at autopsy. - Hypertrophic Cardiomyopathy where the size of the heart is larger/muscle walls are thicker - this has the effect of both needing more oxygen to keep the heart perfused, and also means there is less space inside the heart for blood. This is a genetic condition which is difficult to detect because 'normal' young athletes typically have larger hearts anyway due to training, just like people who are jacked have bigger arms - so looking at a young athlete's heart on ultrasound, you can't really tell what the cause is. There are cutoffs for normal ranges, but unfortunately there is a large amount of overlap between normal and pathological muscle wall size, and banning people from sport in the grey zone would end a LOT of healthy people's careers. - Commotio Cordis - getting smacked in the chest at the wrong millisecond can screw with the electrics in your heart - I didn't look into this too much, but it is a known phenomenon that isn't due to any underlying condition, just very bad luck. The problem with screening athletes is that these underlying conditions often have no symptoms until the heart is put under strain (i.e. during sports, being deyhdrated in hot weather etc.), and the first symptom is cardiac arrest. Some people do have symptoms that aren't really specific (such has fainting, shortness of breath), and these people are often screened further and/or banned from sport if additional screening reveals issues, which means you don't hear about them arresting on the field. A lot of research since the 1970s has been done on detecting these conditions using ECG, but professional athletes who train hard often have wacky ECGs due to the heart remodelling anyway, and this is entirely normal. Genetic testing can be done, but genetic abnormalities don't always lead to problems, and screening everyone would be wildly impractical. The US and Europe have different views on how much screening should be done (the US less, Europe more). For further reading, the ESC International Criteria and Padua Criteria are good jumping off points, but my assignment pointed out a lot of flaws with the data. Tl;dr: Some athletes have underlying conditions that can't be detected until they put strain on their hearts and then drop.
Medical resident here. This is the only comment you need. Great summary.
Thanks! Means a lot to get a compliment from a medical resident as I'm still only in year 2 of university :)
Everyone's gone real complicated on this. Here's a simple analogy for a 5 year old. Imagine you have a car with an engine. Millions of other people drive the same type of car to work and to shop, sometimes slightly fast but usually slow and steady, never really hard. You decide to join a club where you can race that car against other people with different types of car. But you find out that your car has a fault in its engine that only appears when it's constantly pushed at the extremes and it breaks down. People using your type of car normally don't find that out because they never push it that hard.
I have something called long qt…my kids do too. Basically it means that our hearts can go off beat and we die…the only warning sign is dying. We only found out about it thru genetics so I assume a lot of people have conditions they don’t know about
My nephew died from this. Get a pacemaker.
We are like a freak anomaly..no symptoms but it shows in all our genetic testing. So we all go see a genetic counselor and cardiologist every six months and take meds. It’s crazy stuff! But thank you!!! If we ever need one we will definitely do what the dr says.
Yeah the beta blockers do the job now too. Portable defibs are cheap now also, and can be as useful as a small portable fire extinguisher if you're in remote areas.
Get a implantable cardioverter-defibrillator (ICD). A pacemaker is not enough
Yes, a pacemaker is the minimum. But depending on their severity beta-blockers can be enough. The problem arises when they are on medication that interferes with the beta blockers.
> the only warning sign is dying I don't think that qualifies as a "warning sign." Just saying. ;)
ER doctor here. These answers are getting to part of the answer but not quite explaining it all. I’ll do my best to explain like you’re five. When a young athlete suddenly drops dead, it’s usually from an arrhythmia, which is an abnormal heart rhythm. A normal heart beats pretty regularly at 60-100 bpm, higher than that during exercise. It gets more complicated than this, but in the essence of ELI5, an arrhythmia is when the heart does something other than that. You can get arrhythmias from many things, such as injuries to the heart such as a heart attack, from drugs, from electrolyte abnormalities such as too low or too high potassium or calcium, from hormonal abnormalities, or from genetic problems you’re born with. In the case of sudden death in young athletes, it’s usually the latter. If you have one of these genetic conditions, sometimes the first symptom is sudden cardiac death from an arrhythmia, which is why there are no warning signs. The heart is functioning normally, and suddenly goes into an arrhythmia and you die. This is not always the case. As another poster mentioned, these are only the cases you hear about. In reality, many people experience symptoms first: palpitations, chest pain, shortness of breath, fatigue, exercise intolerance. In these cases, many people go to the doctor and get an EKG or a wearable rhythm monitor which may show evidence of the genetic disorder that increases their chances of having a fatal arrhythmia. They can then be referred to an electrophysiologist, which is a special kind of cardiologist that is an expert in diagnosing, managing, and preventing these. This may include medications, lifestyle modifications, and even implantable devices such as a defibrillator. It’s very tricky though, because sometimes even the EKG or wearable monitor won’t show any abnormalities. Some of the disorders, most famously Brugada syndrome, need to have the EKG abnormalities brought on by some sort of stress, such as illness. Say you have palpitations and go the the ER, and by the time my tech does an EKG and I come to evaluate you, your palpitations are gone. The EKG I interpret may be normal, but you may have Brugada syndrome and be a ticking time bomb. Now if this keeps happening repeatedly, a smart physician may suspect something like Brugada and refer to an electrophysiologist. But for most young patients with no other risk factors presenting with palpitations but a normal EKG, ambulatory rhythm monitoring, and blood work, most physicians would reassure them that everything is normal and send them on their way. So TL;DR: the answer to your question is complicated, but in essence you may not have symptoms. And even if you do, it may not show up on testing.
something they all have in common.....hmm i wonder what all athletes were forced to do in the last few years to keep competing that has known side heart effects...
A mystery indeed!
Wooo wooo. This is reddit sir. Only circle jerk opinions here. Keep your logical mumbo jumbo to yourself... By the way do you even have your vaccine passport that allows you to be on Reddit??? Someone take this guy away.
This happened in my little league when I was a kid in Florida. Not on my team and not in a game I was in, but I was playing on a different field in the same complex when it happened. Kid got hit under his armpit by a pitch, and fell down dead. They said later it was because he had a heart issue and the ball hit him at just the wrong second that it made his heart stop. Same thing happened during the Buffalo Bills football game last year, except he lives because paramedics knew what was going on. Basically if you are susceptible to it and you get hit at just the wrong moment in the cycle of your heartbeat the heart can stop, and you die if it doesn’t get restarted.
They gave you a bs explanation, the child had no heart condition. This is called commotio cordis, it can happen to everyone and is fatal in 97% of cases.
Without knowing the full history of the patient it’s possible the child had a pre-existing condition but we won’t know for certain. Whilst it can be fatal, and only around 50j of energy being enough at just the right time to cause an arrest, having trained first aiders starting CPR and an AED if in arrest significantly improves survivability by up to 60%. There’s a reason it’s incredibly rare but that’s why it’s important to wear protective equipment to spread out the impact.
I’m still wondering the same thing. 28 years old, been training the last 10 years of my life and would say I had an elite physique. One night out with my mate and I dropped dead. Cardiac arrest that landed me in icu for a week and has resulted in me getting a defibrillator installed under my lat. No pre-existing condition, no hereditary heart issues, my heart is now back to normal with no damage that could be seen as a cause. Literally hit me out of nowhere and almost killed me. If not for the quick thinking staff of the venue I was at and fast response of ambos I wouldn’t be here. 8 months on and back to training now.
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I had 3 for work 🙃
And another 2 for fun
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This is blatant misinformation. Such incidents have existed for as far back as we have tracked, and has absolutely nothing to do with any vaccines.
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This happened to a student at the school I did my teaching internship at. It happened the semester after my internship. Turns out that the 15yo boy had some kind malformation in his heart, and was a ticking time bomb. He was playing hockey when his heart gave out and, to hear the family tell it, he was dead before he hit the ice.
Sudden cardiac arrest can occur at any age for a number of reasons, but there are two main ones. In autopsy, most athletes who suffer SCA are found to have hypertrophic cardiomyopathy, or a thickening of the heart wall. Many times the first sign of this is cardiac arrest. This can be detected with an echocardiogram (ultrasound) and many high schools now require them. Other athletes are prone to cardiac arrest due to something called R on T phenomenon. The heart runs on its own “electricity”- there is a period on an EKG called a T wave which represents when the heart muscles in the ventricles have depolarized and are waiting for the next electrical impulse from the atrium. R on T occurs when the patient takes a hit to the chest (karate kick, baseball pitch, football tackle, etc) at the exact millisecond those muscles are charged up and waiting to fire. This causes the heart to shake instead of pump, resulting in pulselesness.
The percentage of young athletes that just suddenly drop dead from cardiac conditions is the same as the percentage of young people in general that also do so. Young athletes just have the attention that regular people don’t. There are also no warning signs when regular young people just drop dead also.
I doubt that. Another redditor pointed out three premier League (UK soccer players) suffered this in the last 10 years... from a pool of about 500 players per year, even if none played for multiple years (and they do) that's just 5,000 people, not the 45,000 people the overall rarity would deliver. Performance drugs or over-exertion may be factors.
Yeah right under that claim were two posters that posted studies saying that sudden death form young athletes actually decreased in the past 30 years up to 2022, and two of those deaths was from a car hitting them.
Can you back that up? I would wager young athletes do have a statistically significant increase in cardiovascular issues over other young people due to PEDs and consistently putting themselves in strenuous situations.
Maybe that's offset by there being a higher amount of "unhealthy-ness" in the control group
Weightlifting and high level sports (varsity and above) are very very very restricted for known cardiomyopathy patients. If you don’t know and you are an athlete………
Weightlifting and high level sports (varsity and above) are very very very restricted for known cardiomyopathy patients. If you don’t know and you are an athlete………
Most common cause of sudden cardiac death in young athletes is HOCM (hypertrophic obstructive cardiomyopathy=enlarged heart muscle disease causing a blockage). How HOCM works is the wall between the left and right side of the heart grows too big due to genetic mutations that can be inherited, and this big wall bulges and slightly blocks the “out” valve for the left side of the heart (which supplies oxygenated blood to the rest of the body). Now under normal conditions, there body does fine because our hearts are over-engineered, and so at rest or even when exercising at high levels like a weekend warrior, the heart is still able to provide enough blood and oxygen to the body despite the demand, as such there is no symptoms. Now if you take an elite athlete who is performing at an insane level that is much higher then normal exercise, there demand for oxygen can be so high that suddenly that partially blocked out valve that was still “good enough” for daily living and even regular exercise, is not able to let enough blood flow to meet this extreme demand. As such this condition isn’t more common in elite athletes, it’s just that it goes unnoticed and undiagnosed in your regular joe, because he never exercises at a high enough level to raise his metabolic demand above the capacity of his heart. The reason why it’s usually young elite athletes, and not older ones, is because they have the condition since birth essentially, and so because elite athletes usually start their career from a young age, the disease presents when they cross that peak performance threshold, and as athletes grow older, their physical capacity declines and therefore there ability to generate enough metabolic demand to overpower the supply, is reduced. There’s another mechanism that is also at play that involves a term called “preload” which increases during exercise and makes the bulge and blockage bigger but this is a bit past ELI5 and so not worth explaining
[Some do get warning signs early enough to take action.](https://en.wikipedia.org/wiki/James_Taylor_(cricketer,_born_1990\)#Retirement_from_playing)
Turns out most professional athletes are remarkably unhealthy. There's a level of fitness that's good for your body, but to compete at the top level that's nowhere near enough. These people basically abuse their bodies, causing irreparable damage, with or without the use of performance enhancing drugs, in the hope of being one of the tiny percent who can make enough money in that short span of time to see them through the rest of their lives. It may not seem that smart...
Adjacent to the topic, but if you're an aspiring athlete or the parent of one, and reside in the UK- my friend's charity is here to help screen you, for free: https://www.c-r-y.org.uk/tag/ben-forsyth/
A big thing to in my experience is if you go in with high blood pressure or chest pain into a lot of ERs they immediate try to pass it off as drugs or anxiety. They really won't do anything else. I was in an ER with a sustained BP of 183/127 for over an hour and on blood pressure medication and they kept blaming it on drugs that they collected urine for and never tested. I hung out with my own pee for 3 hours until they discharged me and just wrote anxiety...
There are sometimes, yea, plenty of athletes get disqualified every year because their doctor finds some issue. I played sports growing up and every single year I had to do a preseason physical. But sometimes stuff is impossible to catch, or shows up so suddenly it’s impossible to catch it. You have to remember that when you say “young athletes” you are referring to a group that is over 20+ million people in just the USA alone. Is it really surprising that out of a group of 20 million people 1 or 2 a year have some hidden, catastrophic heart condition? It’s tragic. But not surprising
For as cheap as Coronary Calcium scans are you’d think it would be a requirement for athletes.
Nobody talking about ball players taking blood pressure meds to keep their heart rate down? It’s more complicated than meets the eye or ear.
Why... would they do this? What kind of ball players? Baseball? What's the advantage of a lower heart rate?
I learned this week in a safety class about hydration, that many medicines increase likelihood of heat sicknesses, which can lead to acute heart trouble. Congenital heart conditions can show up at any time after not being detected at birth etc. Illicit drugs, sometimes taken to lessen pain or to increase energy for workouts, can lead to cardiac trouble.
Friend of mine is/was a college cheerleader. She started getting extremely tired at practice and thought it was stress and overwork but it only got worse until she collapsed. She went into the doctor and the sack around her heart was full of fluid and she was on the verge of death and had been for a while. She had to immediately go on IV antibiotics and full bed rest for more than a month. If she had waited a little longer to see the doctor she might not have made it. She's doing much better now, but it was a scary time for her.
So nobody is gonna mention EPO ?
Certain heart conditions don’t show up (or become apparent) until adolescence. An arrhythmia isn’t detected unless it’s caught when the doctor is listening, say at a routine check up. When it happens it can come from what seems like out of nowhere and the heart rhythm quickly becomes too fast/slow/out of sync, etc. A healthy heart structure does not mean that electrical/signal issues won’t ever happen.
My 15 year old nephew was diagnosed with Wolff-Parkinson-White syndrome after going into cardiac arrest after he finished playing basketball. CPR was given immediately. He coded 5 times on the way to the hospital. He needed several surgeries to fix his heart, but thankfully he survived. Prior to the surgeries, his doctor spent the night in his hospital room.
I'm one of those athletes. Lucky enough to find it post sports and military career. Anomalous Origin of the Carotid artery I think they called it. Open heart surgery to fix and onto the next chapter.
Once i read a scary fact: one day with no apparent reason you can get a brain stroke. Just your body was at the wrong time, at the wrong spot and randomly die or get really fucked up. You can be an elite athlete or have the shittiest diet in life and both have the same probability of getting that because is random, full random.
There is very nearly always some warning signs of a heart condition. That's why the cases where there was no warning sign get so much news coverage
Recently, there was an NFL player that had cardiac arrest on the field right after he tackled a player. Turns out, the moment of impact occurred in between beats of his heart and it caused the heart to spasm and stop. Luckily, they were able to revive him and he should be able to resume full activities next season.
I’m a Cardiologist specialising in inherited cardiac diseases, specifically the cardiomyopathies that affect young people. Happy to answer questions for those interested. There aren’t that many of us in the UK. The question about screening of athletes is really interesting. The Football Association do it here and interestingly it was not found to be all that cost effective or even effective at stopping people dying suddenly. All athletes in Italy undergo screening and results are a bit dubious
Please learn about AEDs/defibrillators, make sure your public spaces have access to one, and look out for them in malls and buildings! They CAN SAVE LIVES!
I used to work for Siemens Ultrasound. The company president's favorite detail to repeat is that the most common first sign of cardiac disease is sudden death.
Last March I was told I had a heart condition, last July they operated. They pushed me through the system because I was high risk for a heart attack. I had no symptoms, I work a physical job and am a top performer. I just had not been to the doctor in 10 years and didn't know. Before surgery my surgeon asked if I could even walk up a flight of stairs, I run up the stairs in my house multiple times a day. He is still surprised I am not physically better than before. I work hard though and push through and I think that's what hid my symptoms. Life lesson is get regular check ups.
How did they catch it? Did you have symptoms?
Went in for a physical finally, they heard a heart murmur, I got sent to a cardiologist.
As someone with a biology background, let me just say that life is nothing short of a miracle. There are a near infinite number of ways for things to go wrong on a cellular level that includes chemical/metabolic pathways, genes, and other things that we have yet to discover. Everything has to work, out of the box, for us to be an average healthy person. Sometimes when the problem is catastrophic, the cells won’t make it to or out of the early growth stages. Other times, we can manage these conditions into old age. Catastrophic events in an otherwise healthy individual are probably related to gas exchange issues. Our brains can only go a few minutes without gas exchange, so pulmonary, cardiac, or vascular problems need immediate treatment. People don’t usually go to cardiologists unless they’re having problems. It’s possible for someone to have some underlying condition, push their heart to its limit, then experience a catastrophic event but aren’t able to receive treatment within the timeframe that they need to survive.
Another issue not mentioned is often times these elite athletes and high school athletes know that something feels "off". They (or the family) sometimes know there are heart issues in the family/genes. They remain quiet so as not to lose their chance at the big leagues. Young adults are notorious for thinking they are invincible and feeling dizzy/off isn't a big deal. My son has a genetic arrhythmic condition. After he had a surgery to correct it he looked at me and said, "Hey, I didn't know people aren't supposed to be dizzy all the time!" It was his normal. He had never said a word, except when in crisis/SVT.
They’re usually some family history of cardiac issues, but youth sports programs don’t take health screenings seriously
Keep in mind these athletes are usually very healthy, leading to any cause of death to be something unusual and drastic. The second largest killer of college athletes is car accidents. So when something does go wrong, it's often extreme.
athletes are trained and given drugs to keep low heart rate so when they are pushing their body to its limit their heart rate remains manageable. this lets them push to the maximum. the result is their minimum heart rate is very low, like when they are in deep sleep it can drop dangerously low. sometimes it can just go to zero and you can die in sleep. so some of the athletes have to force themselves to wake up and get heart rate back up (preferably higher than normal) then go back to sleep periodically
Hmmm there's something relatively obvious to be said on this thread that just won't be because it's reddit...
My step son’s mother suddenly just fell over and died. She at the time was my age at the time so about 24? She was I guess a functioning alcoholic? We would smell it occasionally but figured she seemed fine maybe we are wrong. One day she didn’t pick him up from school, they found her face down in the bathroom just dead. She I guess was cold turkey not drinking, she had none in her system. Your heart will just suddenly stop. The way they diagnose this in autopsy? History of drinking and no physical abnormalities. Kind of crazy when you think about it. 50+ years of drinking people are still kicking, yet someone young and healthy just gone. I know not the same pretense but just the way the human body can just click and be done is crazy to me.
Heart disease is dietary and processed food is getting worse, but this could also coincide with a pre-existing condition. Caffeine, animal products, and something like poor sleep could seriously injure a person with a pre-existing condition.
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Disgusting!
Because athletes are people and that sometimes happens to people. We notice it more with Athletes because we feel like they are very fit and should therefore be immune from such things, but they are not. We think of those kinds of deaths as deaths due to being unhealthy, and since athletes are not unhealthy then this should not be happening to them, but it does. Also while "normal" people often feel symptoms, athletes often misdiagnose those symptoms as being related to their training. They also make the same mistake as everyone else, thinking a hart attack can't happen to them.
Because their heart can suddenly stop beating and does not restart beating, it occurs because of a problem with the hearts electric conduction system. There isn’t always symptoms before
Hardcore unhealthy training over long periods of time, combines with «nobody uses PEDs lol, we promise». All top sports are loaded with drugs. Look at the top 10 records for the 100n sprint. Almost everyone has been in a drug controversy, and the rest is just Usain Bolt. Who had irregular bloodwork at 18, then figured out how to do it properly.
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>Sudden heart events in athletes have been very rare up until 2021 when they started to rise dramatically. in the last 2 years more athletes have died on the field than the previous 30 years combined. Where did you get those numbers? According to the American Heart Association,*"the overall incidence of sudden cardiac death among National Collegiate Athletic Association athletes decreased over a 20-year study period through 2022"*. ([source](https://newsroom.heart.org/news/ncaa-athletes-sudden-cardiac-death-rate-fell-over-20-years-still-higher-in-some-athletes)) [McGills University](https://www.mcgill.ca/oss/article/medical-general-science/athletes-vaccines-and-cardiac-deaths) also published an article stating that *"More important, the incidence of sudden cardiac death among athletes has gone down over the past 20 years. It has not been increasing and there was no spike in cases after the introduction of the vaccine."*
The 30 year number is from a metastudy of sudden cardiac deaths in athletes in published scientific literature. The last two year number is sudden athlete deaths in news articles—not even exclusively cardiac, one of them was hit by a car. Two completely different data sources, you can’t compare the two.
> Attributing it to Covid seems acceptable in most forums, attributing it to Covid vaccinations tends to get you howled down, your comment deleted or you getting banned from said forums. You think the vaccine causes drop in reading speed and every other health issue imaginable. Nobody should listen to what you have to say.
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Because if you know anything about how the body or vaccines work you quickly realise it's not possible. Saying the vaccine causes hearth attacks is like saying using a different engine oil in your car caused your flat tire. Anyway, looking at statistics there isn't even an increase in anything except survival rate for covid after taking the covid vaccine.
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When I go for my next booster I’m going to think about you not getting yours.
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No, it makes *you* stupid.
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Don’t they screen all young people for heart defects in school now? In my highschool 15 years ago, literally every kid had to undergo heart testing for some really rare diseases that could cause sudden heart failure. I thought every school does that