Thousands and thousands of high school and college-age athletes compete in a variety of sports each year in this country, and doctors expect about 100 of them will die annually during competition.
"So that's a rare event, but it has a huge impact on the community," said Dr. Scott Yeager, a pediatric cardiologist at Fletcher Allen Health Care. "It creates a lot of concern. Parents are worried about their children. How can I prevent this from happening to my child?"
But you can't prevent a catastrophic event if you don't first know that a person is at risk. The heart defect 20-year-old Torin Tucker had doesn't typically present with symptoms, so the only way the Dartmouth College cross-country skier would have known about his defect would have been through medical imaging of his heart, which is not typically done on healthy people without cause.
An autopsy showed Tucker's left coronary artery was connected to the wrong part of his aorta, so instead of bringing blood directly to the left side of his heart, it passed between his aorta and his pulmonary artery.
"Now under normal circumstances that really doesn't matter very much because the heart is still getting appropriate blood," Yeager said. "But we think with the exercise, particularly very vigorous exercise, both those arteries get big and they can compress the coronary artery that's passing between them."
They compress the coronary artery so the heart muscle doesn't get enough oxygenated blood, causing a severe, often fatal rhythm abnormality. If diagnosed beforehand-- which again, occurs rarely-- surgery may help.
"Certainly anybody in whom we identified this abnormality, we would not want them doing competitive athletics until there was some intervention. Whether it would be safe after surgery, again, would be a relatively controversial issue," Yeager said.
Regardless, the sudden, unexpected death of strong and healthy young athletes brings unspeakable shock to roughly 100 families each year in the United States. Some aware of their congenital heart defects, and some who were not.
Dr. Yeager says Torin Tucker's heart defect is the second leading cause of sudden death in young athletes behind hypertrophic cardiomyopathy or thickening of the heart muscle.
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