Tech Doc: Tackling heart health for athletes
In 2023, athletes LeBron (Bronny) James Jr. from the University of Southern California and Josh Davis from Utah State University suffered sudden cardiac arrest during their respective team practices. Thankfully, both survived. A 2011 study published in the journal Circulation determined sudden cardiac arrest was the leading cause of death during exercise in NCAA student-athletes, and there are similar findings for younger athletes. According to the National Library of Medicine, reports suggest that approximately 1 in 40,000 to 1 in 80,000 student-athletes die of sudden cardiac death each year.
As a former collegiate athlete and current cardiologist at the Texas Tech Physicians Center for Cardiovascular Health, I’m well aware of this growing health issue.
Sudden cardiac arrest can be caused by a variety of things. The most common cause is in a pathologic and abnormal thickening of heart muscle, called hypertrophic cardiomyopathy, found usually in one part of the heart, but not all of it. This can cause fatal rhythm problems. Instead of beating regularly and efficiently, the heart “wiggles” and doesn’t supply enough blood to the body. Other common causes of cardiac failure are an absent coronary artery and Brugada syndrome, a genetic condition that causes an irregular heartbeat.
Genetics and family history play crucial roles in cardiac health issues. They also factor into the equation to determine whether a person should be allowed to play or compete in a sport. There is a very strong genetic component in cardiac failure. It’s important to know the thickness of the athlete’s heart muscle and whether any of their family members have died from or survived sudden cardiac arrest.
It’s also important to note that depending on the kind of athlete, their heart can experience physiologic adaptations. The heart gets bigger and more efficient in an endurance athlete. For a resistance athlete, the whole heart gets modestly thicker. This means an endurance athlete might have a lower resting heart rate because the heart accommodates extraneous physical activity. An echocardiogram can help sort out whether the thickness of the heart is normal for the athlete, or if the heart is abnormally thick in one part, called hypertrophic cardiomyopathy.
It can be more difficult for athletes to recognize they are suffering from cardiac arrest compared to what non-athletes experience. Both can experience some shortness of breath, but in young, healthy people who are athletically conditioned, usually there aren’t any warning signs. Their first symptoms are relatively catastrophic, and that’s one of the real difficulties of catching and treating cardiac arrest in athletes in the early stages.
Athletes should especially be careful with supplements like raw amino acids and creatine. Whey protein is a safe supplement for athletes to gain muscle mass, but some other supplements can be dangerous for the heart. In general, the problem with supplements is that the FDA does not scrutinize them. Claims can be made about what’s in them, and they can contain things like anabolic steroids even though they don’t appear on the label.
Implementing something as simple as healthy hydration can help save young athletes now and in the long term from developing heart issues. Critical deficiencies in hydration can lead to fainting
spells and the loss of vital minerals. Insufficient amounts of magnesium and potassium can increase the risk of heart arrhythmia, particularly if a person is at risk for that anyway. Heat exhaustion can be an issue, too, so it’s crucial to be mindful and reasonable about hydration.
An electrocardiogram (EKG) is a screening test that records the electrical signal from the heart to check for a variety of different heart conditions. EKG screenings have gained a lot of publicity, as have efforts to require them for competitive athletes at the high school level or higher. While an EKG may not be necessary for every athlete, every athlete does need a family heart health history review and thorough exam with an experienced physician who knows what to do with that information.
Scott Shurmur, M.D., is a cardiologist at the Texas Tech Physicians Center for Cardiovascular Health and the Texas Tech University Health Sciences Center’s Department of Internal Medicine chair.
This article originally appeared on Lubbock Avalanche-Journal: Texas Tech HSC Doc on tackling heart health for athletes
